Well crap!

“Not bad,” says the doctor, looking at the screen, “Not bad at all.” There’s a long tube with a teeny camera attached and my innards are bright pink on the screen. “Yes,” he says, “this is g--. Oh. Well.”

“Oh. Well.” is the equivalent of “Uh ho,” which was my former doctor’s expression when he spotted something he didn’t like.

“I thought we were good, but there are two little tumors there. Not bad ones, though…”

“Surgery again?” I ask.

“Oh yeah.”

Doctors aren’t supposed to say, “Oh yeah” in that offhand manner, like they’re ordering the Turkey Mile High after the 18th hole at the country club.   

Well crap. This will be the sixth bladder cancer surgery in less than three years. I know the drill by heart, and I am sooo tired of it. Full recovery, where I feel myself again, takes about three months. The first two weeks are truly unpleasant. I won’t get into the details about how a full grown man feels when he has to pee every twelve minutes, which, all in all, is still better than having a catheter attached to my private bits.

I sit on the examination bed with the paper blanket on my lap. The doctor shakes my hand since we are, after all, partners in this endeavor, aren’t we? The nurse busies herself. I’m trying to collect my thoughts.  She says, “You can leave now.” I know, this and wish endless catheters upon her in her old age. I try to remember if this is the same nurse who once asked me if I was sure of how to spell my name.

Double crap. I had convinced myself this would go one of two ways: either I’d be clean and cancer-free for the third time, or the doctor would tell me he’d have to take out my bladder, and I would say, no, that’s not going to happen, because that’s something I decided when I was first diagnosed. I’m not going to live with a permanent tube draining the urine out of me. There are limits to impropriety. I was not ready for the “not bad, just a couple of small tumors.”

I go home, stop at Starbuck’s and buy a donut, which I swore a few months ago I would give up and, until just now, had managed to do. Not today. The donut tastes really good and I can feel each and every 280 calorie dancing in my mouth; a tango, I think. 

When I was first told about the cancer by a doctor who refused to use the C-word, I walked home from the medical office and stopped to eat something at two Starbucks, one pizza place, one Panera, one Caribou Coffee and one more pizza place. Then I got home and threw up. After the third surgery, I went through a depression as deep as a black hole. This, I learned, is not an uncommon side effect. In fact, post-surgical depression has its very own entry in the latest Diagnostic and Statistical Manual of Mental Disorders and more than ten pages of entries in Google. It was never mentioned by any medical personnel.

So come September 20, it’s back to the hospital, to the anesthesiologists who will lecture me on my refusal to take painkilling drugs, to the surgeon who will undoubtedly leave after the operation without letting me know whether it was success or not, and, I almost forgot, back to peeing blood…

Crap.    

 

   

 

 

 

 

Dear Doctor: What Not To Say

In the next few days I’ll be going to the doctor’s for my three-month post-cancer-surgery tests. I’m naturally anxious, afraid even. I’ve been found cancer free twice and cancer-not-so-free three times, so if you do the math, you can see there’s good cause for concern.

My surgeon knows me, ahem, intimately you might say, and I’m on friendly terms with most of the people in his office. They’re all pretty good people, but on occasion they behave less than ideally.  So this is for you, Drs. K, Dr. L and Co.; a primer on how to behave and what not to say to a patient.

Do not say:

“Uh ho.” This when you are scoping out my innards with one of those clever tiny little camera probes. “Uh oh” is simply not reassuring.

“Hmmm. Will you look at that!” Not recommended while the patient is on his back clenching his jaw and driving his fingernails through the palms of his hands.

I’d also suggest that, when you’re conversing with another doctor in the patient’s presence, you stop pretending the patient is either not there or deaf. One of my surgeons once said to his anesthesiologist, “How does he feel? How would you feel if someone was about to butcher you?” This did nothing to raise my comfort level.

And from an anesthesiologist: “Hey, don’t worry, I haven’t lost a patient yet.”

From the nurse trying to insert an IV needle. “You have really bad veins. Let me try again.”

From the nurse pushing my bed to the operating room, to another nurse doing the same with another patient. “Race ya!”  Actually, that one’s pretty funny…

From the nurse inputting information in the pre-op room. “Are you sure that’s how you spell your name?”

Here’s another grievance: On two occasions, you--the surgeon--had left the hospital by the time I came to. I was told I’d get to talk with you in three days to a week, so I left the hospital without knowing if the surgical procedure was a success.  That’s thoughtless and inappropriate. I understand missing your tee time is important, but so am I.

Also, when I do finally get to see you to learn the outcome of the surgery, don’t keep me waiting unattended for an hour and fifteen minutes. At least get a nurse to check in on me every now and then to make sure I haven’t opened a vein in the waiting room.

Don’t say, “I have an important thing to ask you,” and then query me about the French restaurants in the neighborhood.

Don’t tell me, “I know what it’s like,” unless you’ve suffered a bout of the same cancer I’m trying to combat.

And to all the other physicians I’ve seen during the years--do not say, “I have NEVER had any of my patients complain about the things you are complaining about.”

Don’t say, “It’s easier to remove it all.”

Or during a post-op assessment, “Don’t be so stressed!”

Or, “You may feel some discomfort.” Really? No shit!!

To the dentist--do not say “Oh, Dios mio!” when performing a root canal.

And finally, “Well, I just don’t know what to say…”

 

 

 

 

 

 

Vanishing Wildlife

One of the blessings of living where I do in Northern Virginia is that I am a scant few miles from the Potomac River. Be it rain or shine, and in any season, I can drive 20 minutes from my home and be at one of several wildlife sanctuaries that surprise and delight me each time I visit. Earlier this week I went with a friend to Dyke Marsh, a preserve a few minutes from George Washington’s home of Mt. Vernon. In an hour, I saw a bald eagle, an osprey, great blue herons and egrets, a red tail hawk and a  number of what birders apparently refer to as ‘little brown jobs,’ small, difficult to identify birds such as relatively unremarkable sparrows, warblers, wrens or finches. After a four-decade-long friendship with a serious birder, I can now identify about a dozen birds, of which I am very proud.

The walks encourage idle conversation. Is that sumac or poison sumac? The two plants are remarkably alike but the latter will inflict a rash that, if you’re seriously allergic, may take you to the emergency room. And look! A giant freshwater snail shell, the largest I’ve ever seen. And why, after years of trying, can’t I get an American locust to grow in my yard?

The talk need not be about nature. This week, it centered on the little-known fact that J. Edgar Hoover, the fearsome first director of the FBI, is buried right next to his lifetime companion, Clyde Tolson in Congressional Cemetery right across the river.*

The same day saw us go to Huntley Meadows, a wetland normally full of beavers, muskrats, foxes, deer and any number of reptiles and amphibians. I’ve been going to Huntley Meadows for years and a large area is now a plant-less mudflats, as the park has been slowly filling with silt and debris, which has reduced the water depth and affected the wildlife habitat. A lot of this is due to new construction with poorly planned drainage systems. A restoration project is underway but it’s unsure as to its success, since beavers (I did not know this) have a tendency to up and change neighborhoods at a moment’s notice if they no longer care for their environment. I’ve also heard that poachers have taken a large part of the deer population.

I don’t know how many miles of trails there are in Northern Virginia. Hundreds for sure, all different. A personal favorite is a hidden bower of bamboo that reminds me of the wilderness in Thailand. Another could have been lifted from Germany’s Black Forest. One thing I’ve noticed as years have gone by is that the fauna--other than birds--is disappearing. Two decades ago a hike would have included rat snakes, turtles of many varieties, skinks, an occasional fox or opossum and, once or twice, otter. It’s been at least ten years since I’ve seen an otter or a possum, and three since I’ve seen snakes, once ubiquitous in this area.

Development is mostly to blame, though global warming is at fault as well. I’m not sure how long what is left of the fauna can withstand the pressure of new malls and parking lot. I do know that the amount of impermeable surfaces in my area of the world is growing at a frightening pace. Trading wildlife for tarmac seems like a pretty bad deal.

*In the 60s and 70s, J. Edgar’s long-standing relationship with Tolson was the best worst-kept secret in Washington. It was common knowledge that the chief of the Federal Bureau of Investigation detested Blacks, Commies, hippies, agitators and homosexuals. He kept voluminous files on everyone from JFK to Martin Luther King, and was not above threatening or blackmailing the top politicos of his era. That he was a rampant homosexual himself was well-known. There were rumors of J. Edgar wearing a red taffeta dress to secret evenings for cross-dressers, and he and Clyde could often be seen dining tête-à-tête at the ritzy Mayflower hotel where some said they had adjoining suites. No one, of course, spoke about this relationship openly for fear of reprisals. The FBI chief could make life miserable when crossed. Tolson and Hoover were inseparable for forty years, and when Hoover dies, he left his entire estate of $551,000 to his companion. Tolson then moved into Hoover’s house.

J. Edgar’s grave is a few yards from Clyde Tolson’s. His final resting place is in the Hoover family plot, one of the rare sites in the cemetery to be surrounded by a fence. This, possibly, was done to avoid grave desecration. J. Edgar was a detested man, and in the minds of many remains one to this day.

Both are nestled in what is known as the cemetery’s gay corner. Next to them, sleeping for all eternity, are several gay war veterans, and William Boyce Mueller, the founder of the Forgotten Scouts who died in 1993.

Mueller, the grandson of Boy Scouts of America founder William Dickson Boyce, founded his organization to honor former Scouts who were gay and, according to a 1991 story in the Boston Globe, to counter the Boy Scouts’ beliefs at the time that gay men were somehow at odds with family values. An early member of the Forgotten Scouts was author Armistead Maupin.

 

Free at Last!

So last week, Wednesday night, specifically, my cell phone adamantly refuses a recharge. I do the necessary fiddling--turn it off and back on, remove the battery, try a different charger, etc,--and nothing doing. In the morning, off I go to my Verizon store where the young man there essentially spends 20 minutes replicating my earlier efforts and comes to the same conclusion. “It’s not charging,” he said.

I answered, “Yes, I know,” and there followed that comfortable silence that comes when two men reach an understanding about something important. Sort of like when you get a bunch of guys around a car that won’t start, and one says, “It won’t start,” and the rest nod their heads.

“I’ll have to call Customer Services,” says the Verizon employee.

Hmm. I thought he was Customer Services. So, long story short, on Saturday I receive my new phone, charge it partially, re-download the apps, the address book, the wallpapers and ringtones and go to the mall, a frightening experience I try for the most part to avoid. Get back home, plug the phone in. Uh ho. No charge. 

Back to the Verizon store where the same young man now greets me with a slight frown. He is not happy to see me. I explain the situation as his eyebrows rise in consternation. A second call to Customer Services yields the information that this particular make and model of phone has indeed been problematic, and should have been--but was not--recalled. Interesting.

Cutting to the chase, I will be getting another replacement, but since phone, battery and chargers are coming from different warehouses across the country, I will not have a cell phone until Thursday.

My first reactions are all anger-based. My second reaction is resignation. I send an email to my friends explaining the situation and telling them that, tragically, I can’t be reached by cell or text. I feel sorry for myself. By morning a transformation has occurred. I’m jubilant. I realize I’m free!  I am no longer tethered to an electronic umbilical cord!

As the day wears on, I come to grasp that my cell phone is a nasty little piece of machinery, an emissary of my self-importance. My attachment to it is nothing short of a frightening self-centeredness that says the world as we know it might end if others cannot reach me right now! And that the lives of others may stop if I can’t reach them right now. The more I think about it, the more unrestricted I feel. Do I really need to be paying a hundred bucks a month so I can look up Conway Tweety’s birthday right now? How much of this instant gratification do I need?

I use my cell to communicate with others when I’m not at home, but whatever I have to tell them can probably wait. Occasionally, I’ll use the GPS. I don’t listen to music on it. I have used it from time to time to translate a particularly weird French word into English, and vice versa. My phone is not connected to Facebook, You Tube, Linked In, My Space or Tweet. Being a Luddite, I barely know how to use these services. Having never relied on them, don’t miss them at all. I can understand the phone’s use in case of emergencies. Others, I know, rely on their cell phones for business, information, and entertainment. I recently watched a bevy of young girls all watching what I assume was the same movie on their cells, and I’ve also been in restaurants and watched couples dining and paying absolutely no attention to each other, so intent were they on texting someone not in the room.

My first cell phone was a briefcase attached to a handset. My second one was the size of a brick. I took it to Asia and Africa because my boss told me to, and it never worked there, not once. I can’t remember what my third, fourth and fifth phones did, though I do recall an outrageous bill received after a trip to France.   

My present phone--before it went belly up--had features I neither needed nor understood, and frustrated me with useless apps I could not uninstall.

The future, I understand, is a Google-based set of glasses which will allow me to issue voice commands to do almost anything.

Great, I’m sure, but not for me.

Dear Jeff Bezos

Dear Jeff Bezos:

I live in the Washington area and used to work for the Washington Post, which I understand you just bought for $250 million. I’m pretty sure you got a good deal on the purchase of an iconic institution that has played an important part in shaping recent American history.  I am also a subscriber to the Post and have been for years. For the past few days I have been reading how you will revolutionize the newspaper.

I hope you do a better job than your employees at Amazon Seller Support.

Allow me to explain.  For several years now I have sold my used books through your company. It’s not the best deal; Amazon takes the bear’s share of the money I make there, but it’s quick and automated so posting a listing is easy. Or it was…

Yesterday I tried logging into my seller account. I’ve recently sold some books and needed to ship them but rats, my password wasn’t working.  I tried various permutations. Nothing doing. Allrightee then, this has happened before when my account was hacked.  I changed passwords, got a confirmation email and tried again. Nope. And again, nope again.

So I clicked the help button and was told to log into my account to get help, which was rather silly since that’s my problem in the first place--I can’t log in. That’s when I noticed that Amazon customer support, like a number of big companies, doesn’t list a phone number. I Googled it, got the number. Talked briefly to an operator who told me she would transfer me the Seller Central Customer Service.

Music. I think it might have been a piano concerto by Ravel but it was a bad connection so I can’t be sure.  From Ravel we went to Poulenc but once again, who knows. Poulenc to Rachmaninoff.  Oooo! Night on Bald Mountain, one of my favorites, really bombastic and over the top. Then something soft, a lullaby I might have known but couldn’t identify. I waited twenty minutes in all, then decided that obviously somewhere between classical numbers, I’d been forgotten. I hung up, redialed the original number, was put on hold again and lucked out: A reprise of Mussorgsky.

Another 15 minutes and a voice finally asks, “Can I help you?” I haven’t spoken in so long I need to clear my throat first. I give all the relevant information. The voice--a really pleasant voice, I must say, so congrats, Jeff, on that aspect of it all--suggests my browser has been hoarding cookies and I should clear the cache. I do. “Did that solve the problem?” No.

I am told to download Firefox, and do, with some misgivings. I sign into my Amazon account and Firefox sends me a message: “This is an unsafe site!!!”  I inform the Amazon voice, which chuckles. “No, it’s OK, really!” I press the necessary keys. My account is still blocked.

Now the voice tsks. “I will refer this to the engineers! We will solve this within 12 hours, I hope!”

I say good bye to the nice voice which, in retrospect, strikes me as mildly New Delhi-ish. Or perhaps Mumbai?

In minutes I get an email titled, “Resolution for Case ID 107641011.”

I click on the web address and am back to the Amazon Seller Central site. I enter my password. I am rejected, just as before.

At the bottom of the Resolution email, I find:  “Have we successfully answered your question?”

I punch the “No” button, which takes me to the Amazon Central Seller site, which I cannot sign into.

There is something Kafkaesque about all this, and anyone who owns a computer has such a tale.  But this is Amazon! This is the company of Two Pizza Jeff Bezos!

Sorry. I’m getting carried away.

My point, Jeff, is that the engineers at your company have created the perfect Catch-22. I can’t get help unless I log in, and I can’t log in.

But I understand. S**t happens.

Just promise me you’ll do a better job with the Washington Post.

Thank you.

Letting Go

I’ve come to believe that the story of an average life is nothing more than a recitation of things given up. From the moment we leave the womb, or are wrested from it, to the time when we give up life entirely, whether by choice, nature or accident, we are governed not by what we have but by what we have been forced or agreed to abandon.

There’s nothing either nihilistic or particularly dark about all this. For most of us, the gradual leaving behind of infancy, childhood, adolescence, etc., has no mystery to it. One phase begets another with relative comfort. At an early age we go from home to school, abandoning the safe for the not-quite-so-safe. We realize that there is more to life than parents and siblings. In fact, we take these first steps toward separation with a great deal of anxiety. As we move from grade to grade we forsake subjects, teachers, fellow students, activities and interests, the buildings and playgrounds with which we’re familiar, even the familiar smells. We stop reading picture books and fairy tales and begin dealing with the stuff of life--we can identify large joys and bitter disappointments. Schooling is the proving ground of letting go; it is where we learn that nothing we have can’t be replaced.

Eventually we ditch our parents and, particularly in the West, our hometowns and states. We make strange places our own, adopt new ways, languages, mannerisms. We put down new roots, fragile ones to be sure, in different environments. We get jobs, bringing a halt to free time and freedom of choice, and with employment we establish a sort of Peter Principle that will guide us the rest of our lives. We live up to and somewhat beyond our means. We get married and give up the life of a single person as we assume a role that is part of a bigger unit than one.

Eventually, our children repeat the exact same process; they leave us as we have left our own families of origin.

In time, after a life of work and procreation, of raising and furthering, we retire. We abandon the trappings of a work-run, family-based life and take our ease, adopting a less demanding lifestyle that more often than not no longer includes the day-to-day rigors of work and children. We minimize the administration of life, and we happily abandon those things we once thought were vitally important.

Somewhere along the way, we also let go of harmful behaviors. As we get older, we strive to stop drinking, or smoking; we proudly give up sugar and gluten and red meat. Our mortality makes itself known. Or perhaps we contract an illness that forces us to stop behaving in a certain way. We can no longer safely comport ourselves as we did when we were younger. Our reflexes slow, our memory falters; we realize we have once again changed, and this new metamorphosis entails the forsaking of favored comportments. And so it goes. We give up small things for large ones and, on occasion, vice versa.

In 12-step programs, steps six and seven deal with the graceful--as opposed to forced and awkward--elimination of character defects and shortcomings.  Practitioners rely on a higher power to “remove from me every single defect of character that stands in the way of my usefulness to You and my fellows.” I am personally not sure whether adherents truly give up their defects or, becoming aware of them, simply try to minimize their impacts on others. I do know many people in 12-step programs who spend years trying to--and occasionally succeeding at--make a change, altering their persona radically by forsaking behavior that proved inimical to themselves and others. Does this quest make them happier? I don’t know. It’s another form of growth achieved by shedding the past.

I have no idea where this is going so I will now (ha!) let the notion go…

 

 

Reprieve

The past couple of months have been pleasant.  Sure, the weather is by and large Washington-horrid, with temperatures in the high 90s and the humidity nearing solid level. You don’t hike, you swim through the vegetation. The poison ivy this year is particularly nasty, with vines thick as a wrist winding around trees, and the three-leaf clusters nasty underfoot. Deer have eaten the flowerbed in my back yard down to a nub, but I can’t get angry. The fish in my small pond seem happy, almost $500 spent at the vet’s showed my cat is healthy, and the mourning doves nesting in my dogwood haven’t filed for divorce.

People are still killing each other all over the world; political figures who should know better, don’t, as always; and me, I haven’t seen a doctor in more than two months and feel all the better for it.  

This being said, I don’t really dare hope that my recurrent cancer has gone for good. I’ve been told twice that I am cancer-free, and three times that I’m not. So this nine-week period has been a welcome hiatus, but now the fear is just starting to creep back.

Here’s the thing: my cancer, surprisingly, hasn’t hurt, not physically, anyway. The attendant pain has been due to the probing, cutting, burning, and post-surgical treatments; it’s been due to the chemo and the effect of having poisons injected into one’s system-- sheep tuberculosis, to be exact, which is so beyond-the-pall weird that I can barely cope with it. Sheep tuberculosis… I wouldn’t be surprised if I woke up one morning and started bleating.

The next tests are in three weeks. The last time I was scoped, some six months ago, the surgeon was looking at the screen which displayed the inside of my bladder and said, Uh oh. This is not a sound you want to hear from anyone in the medical profession.  I think I said, Uh oh what? But I knew. He pointed out several small areas that looked as if mold had taken hold, and a larger growth that was undoubtedly a tumor. Uh ho.

All in all, there have been five operations so far. The recuperation periods grow longer each time, which worries me. I’m convinced being anesthetized more than a half-dozen times in three years can’t be good for me either, all the while being grateful not to have undergone these procedures wide awake.

I find myself worrying uselessly. Am I more tired than normal? Am I sleeping enough, or too much? What’s that twinge in my lower abdomen? Why are my legs sore? And that slight raspiness in my throat? I can see myself slipping into hypochondria or some other schizoaffective disorder.

                                                                                                     
One positive thing: I’ve stopped looking up symptoms on the internet. I did that one day some months ago and among the possible reasons for feeling as I did was pregnancy. I’m realizing more and more that, though some sites are informative and well-researched, a lot more are not. And the fact is, each incidence of a disease, be it cancer or something else, will vary greatly from person to person. I have heard of people surviving pancreatic cancer and dying of melanoma. Odds vary greatly according to past health, age, gender, and even outlook.

So I’m grateful for the doctor-free time, for not sitting in waiting rooms, for not lying in a hospital bed waiting for the nth person to come and explain why the surgeon did not come and see me after the operation, and yes, I’ll be told of the results in a week or so.

It’s hard won gratitude, to be sure, but the alternative isn’t worth considering.