"Whatever takes us to our edge, to our outer limits, leads us to the heart of life's mystery, and there we find faith."--Sharon Salzberg

Wednesday, May 26, 2010

In Loving Memory

This week's blog was going to be about my attempts to make the transition from active cancer patient to recovering cancer survivor. But if the last six months have taught me anything it's to expect the unexpected. My father died suddenly on Tuesday afternoon. While my head is full of thoughts, I'm at a loss for words. So I've turned to Thich Nhat Hanh to express my feelings about this moment in time:

Wednesday, May 19, 2010

CheMo' Better Blues

Of course, there are a lot of ways you can treat
the blues, but it will still be the blues.

Count Basie

Monday was supposed to be the first day of my last round of chemo. It was with great anticipation that I sat in the reclining chair awaiting the stick of the needle that would begin this final series. The fact that my chemo nurse, Susan, was not able to find a working vein was an omen of things to come. After the third attempt she whispered, "I already broke my two tries rule so I'm going to have someone else try." As another nurse came over, I dug my fingers into the armrest and awaited the fourth puncture. She hit it on the first attempt. "I love that vein," she said with a hint of pride. However, she had forgotten that she needed to get a blood sample and had to remove the tape that held the IV needle in place, taking with it a good patch of arm hair. "That hurt more than the needle sticks," I only half-joked. Finally, my blood was drawn and I awaited the news of the CBC results.

Before long, Susan returned with an apologetic look. “I'm sorry, that was all for nothing," she said. She handed me the results of the blood test and pointed out that my white blood cell and neutrophils (the most common type of white blood cell comprising about 50-70% of all white blood cells, according to wiseGeek.com) counts were low. This meant there would be no treatment this week and that I would have to come back on Friday for a recheck. (If my counts are up I start on Monday, the 24th, and my last treatment will be on Tuesday, June 1st).

Needless to say, I left the office with a bit of a drag to my step. What would I do with another week of waiting for the end of chemotherapy? It was as if I was a little child running downstairs on Christmas morning to find that Santa was stuck in the chimney and the only thing to do was wait until he shed a few pounds and could slide down to deliver his bag of goodies.

As I sat in the parking lot on that rainy Monday, I anticipated that I was going to be ruminating about this all week. Meditation, qigong, reiki, and even a few cold margaritas would help, but there was no way I was going to, in the words of my personal yoga instructor and friend, Sherry, “dump the grump.” So I did what any self-respecting, soon to be fifty-year-old, does when he has the blues. I wrote a song about it. Like ta hear it? Here it go:

My arms are achin’
My nerves are shakin’
Ain't front page news
Just the chemo' better blues

My counts been droppin’
So the treatment is stoppin’
Ain't nothin’ I'd choose
Just them chemo' better blues

Like a bird that can't fly
Like drugs with no high
Feeling drunk with no booze
Got the chemo' better blues

Fillin’ the verses
With doctors and nurses
It’s no joke, nor no ruse
Just the high flyin’...
catfish fryin’...
I ain't lyin’...
Chemo' better blues

Wednesday, May 12, 2010

Ash Wednesday

Seek a sanctuary,
Respect it, as it is holy,
Walk into it with a bare mind, bare feet
and plain clothing,
Nurture your body, mind and spirit
through a healing ritual,
Leave it with a pure heart
until you find your way to it again.
Master Jin Kwon

Wednesday, May 5th, was my final day of radiation therapy. It was the last of 30 sessions, six weeks worth of ritualistically lying down on a cold table while radiation therapists methodically moved my body into just the right position. I would leave each session with my esophagus ablaze, two very distinct freckled red patches, and three little tattoos that were used as markers to align the Star Trek-like machine that sent out a high pitch squeal while delivering the radiation.

My wife, Kathy (also a psychotherapist), and I agreed that this represented an important milestone in what has turned out to be a very interesting year so far. But how to mark this event? How to celebrate the ending of something so pivotal? This was especially perplexing since our usual manner of celebrating special events, steaks au poivre cooked to perfection and accompanied by a bottle of bold red wine with a nose of red berries and a finish of pepper, chocolate and just the right amount of tannin, was out of the question due to the lingering effects of esophagitis.

It was Kath who hit upon the perfect solution; burn the punch card that the therapist initialed every day to indicate that another session had been completed. This burning ritual would be done with the use of a sage smudge stick (given to us by a good friend, and Kath's self-proclaimed guardian angel), and an abalone shell. I was especially pleased with this idea after the final session of radiation turned out to be very anti-climactic. While I knew there wouldn't be balloons and cake, I was surprised to find that at the end of my final treatment there was no review of the impact of the radiation, no discussion about the state of my recovery and no meeting with the doctor so that he could tell me what a great patient I had been. It was made memorable, however, by my radiation therapist telling me that she would be praying that the treatments were effective and then saying, "I have a special song to play for you." With that, she tuned her iPod to the song "Hit the Road Jack."

At home that evening, Kathy and I stood on the deck with a few close friends. We placed the card in the abalone shell along with some dried sage. For the first time I shared some of the specific details about what it was like going through the radiation treatment process and then lit the card. I was surprised and pleased with how well it burned. Using the sage stick, Kathy then performed a Native American smudging ritual to purify my body and the air of negative energy. After brief words and hugs all around, we returned inside for the ritual opening of a bottle of champagne, and then the rest of the evening we celebrated Cinco de Mayo.

The next morning I took the ashes from the abalone shell and scattered them around our garden. I thought about our ritual and the importance of ceremonies like it during difficult times in life. Most of the rituals we develop are simply habitual patterns that tend to make life simpler; your morning routine from shower to work as an example. When done with intention and shared with others, however, rituals take on a deeper meaning that can be used to reframe difficult situations. In this way they become markers, not for life’s tragedies, but for its triumphs. This is of great importance when facing a health crisis as many of the routines we fall into are done in an almost hypnotic state. This can lead to mindless activities that actually hinder our recovery. Healing rituals, on the other hand, become mindful rest stops for the soul on it's journey through the profound mystery of life, and they reconnect us to those who join us along the way.

Tuesday, May 4, 2010

Armistice Day

The best victory is when the opponent surrenders of its own accord before there are any actual hostilities... It is best to win without fighting.
Sun Tzu--The Art of War

Sitting in the chemo room last week, a man and his wife approached me after I gave them the international signal for "It's ok, I want to talk." By this, I mean I took out my earphones and turned off my iPod. The man, who appeared to be in his early 70s, asked me "What kind of cancer do you have, if you don't mind my asking?" This is the chemo room version of the jailhouse "What are you in for?" I told him it was a rare thymic cancer but that surgery had removed the tumor. "Is it aggressive?" he asked. By now, I was thinking I should have kept the earphones in and started laughing loudly to the audio book I had been listening to; I hate answering this question. "They say it is," was my reply.

With his wife standing next to him, he quickly told me his story. He had been "battling" prostate cancer for twenty-eight years and it was now in his bones. "The only thing I can tell you," he said "is keep fighting and have a lot of support." He followed that with "God bless you," and left with his wife.

This exchange got me thinking about the war mentality of treating cancer. It seems with many other diseases we manage them, we learn to adjust, or we develop "healthy lifestyles" to offset their impact. With cancer, however, we bring out the big guns. I understand this mentality completely; cancer is a destructive force and the idea of conquering it gives one a sense of control. The war against cancer is as problematic as the war on terror, with cancer being the Osama bin Laden of all diseases. It often strikes without warning, it moves from place to place and just when you think you have it captured it sneaks away into some secret hideaway to plan its next appearance.

The other issue I have with the idea of fighting cancer is that it seems such an unfair fight as the war zone is the body itself. Chemical weapons of cellular destruction are sent throughout the body, while radiation waves create collateral damage. Reinforcements come in the form of more and more drugs to help bolster the bodies depleting defenses. Yes, this is war in all of its non-glory and those of us diagnosed with cancer are drafted to "fight the good fight."

How to find peace during such times? How to soothe body, mind and spirit in the face of such upheaval and avoid the inevitable PTSD that comes from having to face such a ruthless enemy? One of the strategies to move into the spiritual demilitarized zone of Zen and practice of mindful meditation.

The core of Zen practice is the unconditional surrender to the now, to accept what in the East is called the "suchness" of life. To be present with whatever is happening puts an end to the psychological warfare that is ever-present when we face a crisis. Zen calls upon us to look deeply into our struggles and to see that they feed on our illusion of separateness and control. This is not a call for surrendering to illness and letting it have its way. To the contrary, it is marshalling our deeper inner knowledge that all things are one and that our energies are best used in service of this truth.

In a practical sense, this allows us to heal our shell-shock and seek the true freedom that comes from intentional awareness. We can still hate our disease, rail against it, hold protests and march in honor of its defeat. When this is done with our full attention, we turn battlefields into practice fields, where all events become meditative moments that enrich the soul. In this light, even putting one’s iPod shield back in place, becomes an act of self-kindness that tells the world, “This warrior is heading for Switzerland for some neutrality and perhaps a spa and a fondue.”