Nothing is black and white. Not abortion, not gun control, not the role government should play in our lives, and not whether a person is good or bad.  But in the end, we measure the gray and make a decision: black or white.  We all do this, whether we admit it or not.  A man leads an exemplary life, is down on his luck and finds himself addicted to drugs and commits a crime.  We weigh it and decide: good man who made a mistake or bad man who couldn’t appreciate what he had?

What about us as a nation? The answer is simple, of course: we are a great nation, a great people.  Flawed, but striving to adhere to principles that make us all proud. Freedom, liberty, justice.  Fair treatment of all, a constitution that is the envy of the world.   We have a history of helping those who need help.  We believe in truth and facts and optimism and strength and compassion.  Yes, we are flawed.  We have had (and still struggle mightily with) the iniquities of institutional racism, of unfair treatment of women, of putting our own interests ahead of the world at times.  We are indeed flawed, but we know it, and for decades we have constantly compared who we are to whom we strive to be.  It is how we want our children to be, our loved ones to be, our leaders to be: always striving for a greater good.

This is the answer many of us have been telling ourselves during the past three years in order to understand and explain what has happened.  Yes, there are people who do not believe in these core American principles. There are among us those who embrace racism, nationalism, selfishness.  Who see our needs as greater than the needs of the world and are willing to sacrifice others for our gains – instead of adhering to the values on which we were born as a nation, values that would naturally lead to our own well-being as well as that of others, not either/or.  But these people have always been a minority and they represent a “flawed” part of our nation.  They are part of us, still members of the family, but not the ones we are proud of.

Starting two years ago in 2016 with the election of our President, many of us have been saying “this nationalism, this racism, this denying of facts, this blaming of others, this declaring of enemies, this incessant selfishness over principle, is not us.  It is an aberration.  It is an exception.  It will run its course.”

But we have been wrong. Yes, everything is gray.  There are many reasons why the election went as it did: a minority of voters won the election; too many people stayed home; there were mistakes made.  But in the end, in the voting booth, everything is reduced to black or white. We, as a nation, elected this president. We, as a nation, are behaving selfishly, racially, nationalistically, foolishly.  We, as a nation, deny facts and smear anyone who disagrees with us. We are now dominated by the flawed part of who we used to be.  It is time to stop saying this is not who we are.  This IS who we are, because in the end, everything is black and white.

It is a dark, heavy, dangerous time.  It could stay dark for a very long time and it will if we believe and act as though it is really a sunny day and there is just a cloud passing overhead.  America can be great, even as we carry the burdens of our flaws.  We are great when we do the right thing and at the same time strive not to do the wrong thing. But that is not who we are today.

Are we lost? No, not yet.  We can throw off the darkness.  We can rely once again on the principles we were founded on.  We are not lost because we can move the shadows back to being a part of us but not who we are.  And the only way to do that is to vote.  Never has it been more important say to the world and to ourselves: this is who we are.

A little context: forty years ago I registered as independent/no party affiliation.  I have remained so ever since.  I vote policy and conscience, not party.  But clearly I lean more toward the policies of the Democrats.  My thoughts below are not about that leaning, but about the much bigger issue presented by the current divisiveness in the country.

If there is a change of leadership/control in the House of Representatives this fall, I don’t know what will happen, but I know what should – and could – happen.  And no, it may not be what you are thinking I have in mind.

Control of the House and Senate flip all the time.  And the party in charge then tries to move their policies forward, block the efforts of the other party, and claim they want bipartisanship but rarely get it because of animosity and intense partisanship.  The current House and Senate tones have almost without exception followed the style of Trump: bash the other side, claim bad intent by the other side, lock out the other side.  Far worse than any time when I have been alive, it is full-out war – not for ideological reasons, but because it is now the Trump party and that is how he rolls.  Fearful of his retribution or actually supportive of his approach, the party in charge will not push back and will instead copy his rhetoric and attach approach.

So if the Democrats take back the House, they should do the same, right?  Start impeachment proceedings, block everything the Republicans try to do, bash them mercilessly and ignore the truth.  Fair is fair, yes?  When the dog that has bitten your hand suddenly is in the weaker position, you should bite its paw, right?

Here’s what the Democrats should do if they win control of at least the House: shake the hands of the Republicans.  Tell them there are policy disagreements but we must work together to move the country forward.  Yes, legislation more consistent with the Democratic platform will be introduced and passed, but it will include voices from the Republicans, it will include concessions from the Democrats, it will be as bipartisan as possible.

Why is this the right thing to do?  Because it IS the right thing to do.  No revenge, no retribution, no tit-for-tat.  The Republican Party is in shambles, it has become the Trump party.  But we need a strong (at least) two-party system and the Democrats can both win the battle and help the country win the war by helping rebuild the true Republican Party.   Shake the hand/paw, don’t bite.  Make us all proud, including those who are no longer here to see it – and yes, in the days after his death, I am thinking of John McCain, who represented exactly this approach.

Tonight Trump will tell the nation the name of his pick for the open seat on the Supreme Court.  He will choose someone who is as much a lock as possible to support overturning Roe v. Wade and other critical decisions that do not fit with the views of his base and other groups who side with Trump because he will forward their political agendas.  Why will he do this?  Not because he does/does not support those views, but because it will ensure his base continues to support him, no matter the actual size or proportion of that base as related to the rest of the country.  As I write this, we have no idea if that person will be confirmed by the Senate and how he/she really will vote on key issues.  But everyone knows the goal.

This makes me wonder what the criteria should be for selecting a Supreme Court justice.  Of course, I want someone who supports my views of the universe, but for a moment I am going to pretend that is not the case.  Which leads me to the unbiased answer to this question being: Supreme Court justices should be people who interpret the Constitution and consider precedent based on (a) the intent of the framers and (b) evolution of societal thinking.  Sounds pretty straightforward, but it is both (a) complex and (b) open to manipulation.

It is complex because interpreting the constituion without bias is tough.  I respect that people have differing views of what the framers intended and how strictly we adhere to that principle, and I vehemently disagree with many who take an overly strict position, but at least I respect the argument.  The problem is when we see people contort their interpretation of the constitution to support their bias – they already know the answer on a particular issue and just create an argument to support it.  That is what Trump is doing, but it is not what a Supreme Court justice should do.

The exact same principle applies to deciding how important precedent is and what the role of changing society views is.  It is easy to point to segregation, for example, and other decisions that were clearly supporting inhumane or flat out wrong views, and say they had to be overturned.  And we can look at such things as LGBTQ rights and recognize that society (and maybe people) have evolved, so that needs to be reflected in the SCOTUS decisions.  But we have to be careful about making a very dangerous mistake similar to interpreting the constitution through a bias about certain issues.  Evolution of society and values is not the same as taking a poll.  A poll 75 years ago would have kept blacks as second class citizens.  A poll 25 years ago would have said LGBTQ folks were sick or didn’t deserve full rights.  Evolution is something that happens without necessarily being an immediate majority.  So the Supreme Court justices must look to that, and not just change precedent because the majority (or, in this case, a vocal minority) screams for it.  But that is exactly what Trump is doing.

I want Roe v. Wade to stand and strengthen.  I want other things that would come out of a center or center left SCOTUS.  But I will fully support even decisions I do not agree with if they are reached through the right process by issue-neutral (and that is the key phrase) justices.  The danger of Trump?  That is not his goal.  And it could affect us for decades, moving us backwards, and creating a precedent that future despotic leaders might follow that results in a diminished America, a degradation of values, and the decline of our standing in the world.  Empires have fallen on less than this.

I am a fan of facts.  It’s hard to put aside bias, put aside political views, positions on issues, partisanship.  Even in selecting facts, our perspectives come into play.  But I try.  I’m writing this a few days after President Trump made his comments referring to African and other nations as “shitholes” and wondering why we needed immigrants from countries with poor people, like Haiti, and we should stop.  And we need more from Norway.  He has made many similar comments recently and over the two and a half years he has been in the public eye as a politician.  Those comments are the facts at our disposal, and the absence of countermanding comments (aside from the occasional scripted speech) showing unity and broader thinking are also facts.  Based on this, I think a neutral observer would draw the following conclusions:

Donald Trump holds a set of views that he considers to be valid, evidence-based, and true. Many (not all) supporters of his hold similar views, which explain why he is able to make such statements and not have it affect his base.  It also explains his behavior.  Read through and see if you (a) agree that he appears to believe each of these, (b) agree that his supporters likely believe these, and (c) think that believing them qualifies as racism.  Interestingly, the grandson of Martin Luther King said, following Trump’s comments with him standing next to Trump during a proclamation for MLK, that Trump was “not a traditional racist,” but was “racially ignorant.”

Here are Trump’s apparent beliefs:

1. Countries with people who are black and brown are generally poorer than average.

2. Black and brown people from these poorer countries are themselves poor, uneducated, and unskilled.

3. Countries with predominantly white populations have people that are more skilled, wealthier, and more educated.

4. The US benefits more from having immigrants who are wealthier, more educated, and more skilled.  Unskilled, uneducated, poor people do not bring value to the country.

5. Countries with black and brown people are more likely to have criminals and sick people.

6. To protect the US, we should apply these principles to make sure we bring the best people to the US.  This is not being racist, this is just being realistic.

Are there facts to back up the President’s beliefs?  Of course there are – if you are extremely selective about which facts to choose and decide to ignore the overwhelming amount of evidence proving them absurd.  Just as there are facts to show that climate change is fake.  We can find one out of a hundred climatologists who will provide data showing it is not happening.  But ninety-nine out of a hundred will provide an overwhelming preponderance of evidence showing that climate change is real.

The choice to ignore the massive body of facts and base your behaviors on misunderstanding, ignorance, and exceptions is, by definition bias.  And in this case, racially ignorant and ethically disturbing.  I’ll go one step further: wouldn’t a fundamentally good person question these assumptions that they held?  Wonder if such negative views were truly accurate?  Try to put truth above self-serving rhetoric?  I think the answer is yes.  What do you think?

I’m on a plane as I write this and it is a bit bumpy. A couple of drops, not very far, but enough to make my stomach float and the thought of falling from the sky pop to the fore of my mind. Whenever that happens, I remember two things: first, I’m well-insured and second, the mantra I plan on saying if/when the plane plunges into the ground, which is “I love my bunnies” (yes, despite their young-adulthood status, I still refer to them as “my bunnies”). Both of these are directed at my kids, one that ensures their financial well-being and one that is meant to encompass mine as imminent death approaches.

The foundation of this thinking is a basic premise: I don’t fear death. I’m not anxious to experience – or encounter, depending on your views on such things – it, but I don’t spend much time worrying about it, though obviously (see: this story) I do think about and plan for it. So, since I’ve got some time while the current flight is still aloft, it occurred to me I might find it interesting (to write, if not to share) this apparent lack of fear of death or the delusion that underlies it. Therefore, I interviewed myself and asked a series of questions.

Interviewer: Do you fear death?
Me: Well, first, thanks for having me on your podcast. Second, this is the only question for which I’ll make little jokes and references to being interviewed. And third, no, I don’t fear death.

Interviewer: Thanks for the first, really thanks a lot for the second, and as for the third, I’m not buying it. So let me dig in a bit. Do you fear the state of being dead?
Me: No, since I don’t believe in heaven or hell or purgatory or limbo or the planet Zenagon where the souls of dead humans go. If I’m wrong on any of those counts, then unless it is hell where I end up (which is possible), then I’ll probably be fine. Eternal oblivion obviously won’t affect my happiness during that period. So in general, I have no fear or consternation about the state of being dead.

Interviewer: Do you fear the process of dying?
Me: Yes, if it is going to be painful, be it short or long. I don’t want to suffer, but it’s also true I’ve had some physical situations that were quite painful yet did not reach a level that I associate with a “painful death.” Well, one exception as it relates to prior experiences: I would NOT want to die from an extended kidney stone attack. I suppose I have some fear of a crash of some sort where I am mangled and suffer a slow, agonizing death. Lack of oxygen, be it suffocation or drowning, creates fear in me. That period of suffering plus the knowledge that I am going to be dead at the end is what I hate. Tell me that in three minutes I will be instantly obliterated without pain or suffering and I would not fear the process (again, I wouldn’t welcome it, I just wouldn’t fear it!) – single-casualty nuclear explosion, guillotine, that sort of thing.

Interviewer: Do you fear the emotional and/or psychological pain others will feel upon your death?
Me: Some. My kids will suffer when I die, though as mentioned above I am happy that they will be taken care of financially. We’ve had about 20 years together, so their most formative phases are covered and, of course, they have been the central, singularly most important elements of my life the last 20 years. But I imagine they will miss me and our closeness. Their mom and I worked very hard to make sure they were strong and independent yet still empathetic and connected. Despite our efforts, they have grown up to be strong and independent and still empathetic and connected. So they will be fine, but I do find it unpleasant, if not fear-inducing, to think of my death’s affect on them.

I think their mom will suffer the loss as well, as we both have a long history and remain close. But she is resilient and (cough cough) will also have some financial benefit.

I expect that there will be varying degrees of feelings of loss from my immediate family (by which I mean blood relatives excluding my kids) but nothing that will significantly change anyone’s life.

As for everyone else, there will be a few faraway glances, maybe a tear here and there, several “oh, what a shame”s, but that’s about it. Nothing to cause fear on my part.

Interviewer: Do you fear the record you leave, that somehow it will be inadequate?
Me: No. Whatever I’ve accomplished or failed to accomplish, aside from my kids, will have little effect on the universe. I’ve done some good, I’ve done some bad, and I’ve missed the opportunity to do more of either (with an emphasis on the former). Every day that I’m still around is a chance to improve that record and feel better about it while I’m alive, but the goal is not to create a record for when I am gone – that’s an important distinction.

Interviewer: Related question, but subtly different – do you fear not achieving things that you had hoped to accomplish?
Me: No. I have several things that are very important to me that I want to accomplish. They are, in order of importance, in the categories of (a) continuing to raise my kids, (b) improving my writing and success in that field, and (c) making more money to further ensure my loved one’s well-being both while I’m alive and beyond. But those are things I want to accomplish while here, not things I want to have part of my record when I’m gone (see above).

Interviewer: If I offered you a billion dollars right now to have a painless death in one week (to give you time to say goodbye to loved ones), would you take it?
Me: Stupid question. Well, interesting question (sorry, I broke my second promise from the first question). No, I would not, for any amount of money. Cash is not that important. Ask me if I would accept a painless death in one week to forever eradicate cancer from the world, or to ensure eternal peace on earth, or to guarantee my kids will be healthy and happy for many decades to come (including handling the news of my death!) and the answer might be different. But you didn’t ask that and the planes about to land. Or crash. So that will have to wait for another conversation.

Okay, yes, everyone says “the best hamburger in NYC is…” and then chaos ensues.  I’m not saying they are wrong.  I’m just saying their tastes are different from mine.  In the same way I’m not saying fans of the Khardashians who claim this clan is entertaining and talented are wrong, I’m just saying their tastes are different from mine.  Or those who think OJ is innocent.  Or…’nuff said.

The Le Parker Meridien (wait, that’s too many articles; mixing languages doesn’t change that) is a nice hotel.  Perhaps even elegant.  Particularly the baroque-ish lounge (see future review).  So when you are standing facing the front desk in the high-ceilinged marble-floored lobby and look to your right, you are unsurprised to see a massive red velvet-ish (I promise that is the last time I will append ‘ish’ to a word in this post) curtain covering one wall and stanchions placed in front of it, you are not surprised.  Must be covering some art installation, you think.  That thought dissipates when you see the almost-constant line snaking out from the tiny gap between the front desk and the velveted wall.

Wait in line or skirt it politely to take a look, and you quickly (in the latter case) enter a small, dark, wood-paneled hideaway.  Dark as in “old, left over from the war probably, and belonging in the Village or Vienna.”  About the size of two (NYC) hotel rooms.  There are three or four booths to your left, a handful of tables to your right then some more booths, and a stool-encircled stand-alone bar-ish (oops) structure near the counter where you order.  And order is what you do.  Raised, tiny, and populated in a manner befitting a clown car, The Burger Joint cookery is an open grill manned and womaned by experts.  The opening at the counter is festooned with a hand-drawn/crayoned menu above your head, polite but CLEAR instructions on how to order, and a new sign that says ‘we now accept credit cards’ which leave visitors who generally speak all languages except English peering through the murky light to decide what they want before requesting it.  Efficient and polite and fast are the workers.  Order, stand around until it is ready, jockeying with others who try to appear as though not standing in line but not too far from the grasp of the prep person who will call their name and deliver the magic.  Burgers, fries, shakes, a brownie I’ve never tried…mmmm, take me now.

I have two rules about The Burger Joint.  First, always stop by if there is no line – that means should I come down from my room to go somewhere in the city, see it line-less, I get a burger, then should I realize I left something in my room and pop up and grab it before heading to my meeting, if there is again (note the ‘again’ rather than ‘still’ ) no line, my rule requires I get another burger.  Second rule: try not to finish it in the elevator.

Eat here.

There may be other locations, but this is the only one I’ve visited.  And the first time it was hesitatingly.  Until a year or so ago, the best food in terminal 7 (All United, all the time) was the pre-packaged sandwiches at the kiosks or Starbucks.  There were probably other food places, but it is an indication of their lack of memorability that I…don’t remember them.

So when Klatch opened, I looked askance a few times and then one afternoon when I had too much time at the airport and knew there was too little food on the flight I was about to get on (which means it was probably a regional jet, which doesn’t serve food even in first class except for the “snack box” which qualifies, in some third world countries, as “food” but not if you are looking for a meal),  I lurked outside the line, reading the menu.  Mostly coffee items (hence Klatch, I assume, as in coffee klatch, but I didn’t ask anyone so take that assumption for what it’s worth).  Some breakfast dishes, but too late in the day for those to be available.  And then a handful of sandwiches.  I dove in and stepped into line, ordering the southwest chicken.  I figured it couldn’t be much worse than the pre-made, pre-packaged, pre-tty forgettable ones at the kiosks.  Price was about standard for airport fare – somewhere between $10 – $12 dollars but you can’t complain because the price range is different in airports (and hotel minibars and museum gift shops and arenas/ballparks/stadiums and zoos and anywhere else there is a captive audience willing to pay $4 for a bottle of water that is $.79 in the grocery store).

Quick, efficient service.  A bunch of long tables where you could wait and watch a little tv or the passersby.  Good thing because after five minutes and no food, I changed my impression from fast-food place to not-so-fast-food place.  At the eight minute mark I was beginning to assume they had forgotten my order.  And at eleven minutes I got up to whine.  At that moment they called my name and out came a clear plastic container with my sandwich nestled on white and red paper.  I thanked the counter person, took my container, and immediately had an unexpected sensation: it was warm.  As I walked away, bag on my shoulder, I popped open the lid and grabbed half of the perfectly reasonably sized sandwich.  It was hot and the bread was soft.  Huh.

I took a bite and stopped walking toward my gate.  Warm and soft, but not the way it is when you take stale break and heat it to hide the oldness.  It was fresh.  And the cheese was quite melted.  And a bit spicy (ergo, southwest chicken).  The chicken may or may not have been compressed and water-injected, but it tasted like breast meat and I decided not to open it and dispel the myth.  I resumed my walk, eating the rest of the first half.  Despite my best intentions, I ate the second half before reaching my boarding area.

Fresh bread, melted cheese, nice mix of flavors and textures, and a fair portion.  What an excellent surprise.  Three weeks later (NOT my next trip to LAX terminal 7 – that is a weekly occurrence – but that was the next time I was there and hungry) I visited Klatch again.  This time went for the vegetable sandwich.  At the eleven minute mark, I got up and prepared to whine (I mean, I was the ONLY one with an order in…).  Interestingly, just before I got up, the manager saw me looking at my receipt – hungrily, I suppose – and seemed to have gone and checked on my order.  Three minutes after my almost-complaint, I had the (warm) container which, of course, I opened and ate the contents while walking toward my gate.  Roasted vegetables (peppers? Some other things?), melted goat cheese, and – wait for it – fresh, uncooked spinach.

It was good.  Worth the wait, which may itself have been evidence that they took their time and heated things in convection ovens, not microwaves, but that may just be another myth I don’t want to dispel.

Can’t comment on any of their other food, but eat their sandwiches and tip the staff.

My doctor put on his most somber face.  In that instant I read his mind and heard the words before he said them out loud:

“You have cancer.”

That’s when things got really interesting.  But let’s go back a few months first.

Four o’clock in the morning and I have a pain in my lower abdomen like nothing I’d ever felt.   Sheer agony.  No cramp or bruise or broken bone had ever felt like this.  I postpone my morning bike ride, which I don’t do unless the Apocalypse is well under way.  It must be my appendix on the verge of bursting, so it seems wise to make a trip to the hospital.   Call 911?   Tough guy.  I drive.

In the emergency room, a nurse watches me hobble through the lobby and smiles.

“Kidney stone.”

A couple of days in the hospital.  It’s the weekend – I work from my laptop.  Don’t have to miss any days in the office.  At one point a guy comes to my door.

“Hi, I’m Dr. XXXX (that’s not his real name – you’ll see why…).  Let’s give you a prostate exam!”

Wow, and he doesn’t even offer to buy me a drink.

I go home.  Turns out I had managed to give myself a kidney stone.  Here’s the recipe: Bike like a maniac in the morning and replace most of the five pounds of fluid you lose, then lift in the evening and, if you’re really nuts, throw in an extra bike ride at night to burn off the extra energy.  Oh, and don’t replace those fluids because it’s late and you don’t want to wake up in the middle of the night to pee.  Repeat for a few months until your kidneys are just begging for fluids.  “Please, give me some water, you moron, or I’ll grind almost to a halt and make a stone.”

I’m pretty sure I heard my kidneys telling me that, but thought it was the neighbors fighting.

That was Funny Thing #1.

Funny Thing #2 happens six months later.  On my way to an unrelated appointment, I pass a door with big letters spelling out the name of…Dr. XXXX.  I had no idea he existed anywhere but at the hospital.  So I stop by to look at the report.

The nurse shakes her head.  “If he saw you in the hospital, then you have to make an appointment – the records need to be sent over.”

I make the appointment for the next week and come back.

I sit down with Dr. XXXX.

“I’m glad you came by, since the exam I gave you  six months ago was abnormal.”

I figure he means he gave me an abnormal type of exam, or he behaved abnormally during the exam.   Turns out he meant the results.

“I’d like to do another exam.”

Cavity search number two!  Still no flowers or dinner first.  The results are similar.  Stern look and “I’m finding abnormality.”

“When you say ‘abnormal,’ do you mean two out of three guys have something a little unusual and I’m one of them, or do you mean ‘that’s some weird stuff I felt down there’?”

Straight faced, “I’d like to do a biopsy.”

Have you ever had a prostate biopsy?  It involves five people including a “pre-med student” – isn’t that a college sophomore??? – in a room the size of a large toaster and me with my butt hanging off the edge of a small exam table.  Oh, and a tool that is like one of those geologist’s devices that takes core samples from rock.  That’s right, “core samples.”  Let’s move on.

Biopsies just sound bad.  No one ever ordered a biopsy of a sunny day.  Biopsies  happen because some doctor somewhere thinks something is WRONG.  And they don’t know right away what is wrong.  They send the damn stuff ripped from your body to Johns Hopkins on the other side of the country and wait a very long week for the results.  Okay, fine.  Worst case scenario was a little prostate cancer.  The old saying is that no guy dies from prostate cancer and  most of them die with it.  Uh, wait – that’s for old guys.  I was 48.  Thirty years early for the “don’t sweat it” approach.  But what the hell – I’m as healthy as a horse, strong as a bull, with Olympic lungs.  Invincible.

The next week I’m at work, heading out to lunch with a colleague.  My cell rings and I recognize the number.

To my colleague: “Hey, can you give me a minute?  I’ll meet you in the lobby and we can walk over to Burritoville.”  I go every day.  I mean EVERY day unless a colleague talks me out of it.

I step into an office and take the call.

“Hi, this is Dr. XXXX.”  (Still not his name).

Pause.  “Okay, I’ll assume that pause means you have my results.  What did they find?”

Shorter pause this time.  “I’d like you to come in to discuss the results.”

Big sigh from me.  I’m not interested in drama.  “I assume that means they found something, or you’d say otherwise.  Let’s skip the soft landing – is there cancer?”

I can feel him starting to pause but he interrupts it.  “Yes.”

Okay, that’s a start.  “I’ll make an appointment, but let’s cut to the chase.  Is it bad?”  I assume the answer will be some version of “no,” so I’m surprised when he says:

“There were cancerous cells in most of the samples.”

Now, “most” is somewhat meaningful here because the industrial-strength, diesel-powered boring tool they used to excavate my prostate during the biopsy takes twelve samples.

The burrito that afternoon tastes a little bland.

Back to the doctor’s office.  We look at pictures, read reports.  Prostate cancer, pretty far along.  There are good treatment options, etc.  Oh, but first we have to see if it’s spread.

Spread?  Turns out that you’ve got two options.  Option 1: the cancer is only in the prostate.  Treat it.  How aggressively depends on how far along it is.  Option 2: the cancer has spread beyond the prostate.  That’s unpleasant.  When people die from prostate cancer, it’s because it spread.

“Hmm…so which is it for me?”

Of course, there’s only one way to find out – scans.  Brain, bone, organs, luggage.  How worried am I at this point?  Honestly, not very, but one thing is very much on my mind.  If it hasn’t spread, we treat it.  It’s all business, no matter how far along it is.  But if it has spread, I’m going to have to tell my kids that their daddy might not be around for…well, everything they do for the rest of their lives.  Now I’m getting a little pissed at this cancer crap for potentially causing my kids suffering.  Unacceptable.  If someone causes my kids pain, they are in for a world of hurt from me.  No exceptions.  Prostate included.

So we scan.  Results come back.  The cancer is knocking at the door – it WANTS to get out, it’s TRYING to worm its nasty little self out of my courageous prostate, but it hasn’t.  Not yet at least.  Funny Thing #3: if any of this had happened a few months later – the kidney stone, the unrelated visit to the office – someone else would be writing this because I’d be…uh, gone.

But that’s not what’s going to happen and I like the odds now because it’s business – treat, recover, move on.  And the conversation I’m going to have with my kids is very different.

Quick side note here.  If not treating it like a life-threatening, world-changing, terrifying event sounds blasé, that’s because, as anyone who knows me will attest under oath, I am a bit of an odd duck.  I care about two things: my kids, and getting things done.  In that order.  The first is covered at this point, and the second is on deck and ready to bat.  Freaking out won’t help.

Come back later and read the rest.  And by “rest” I mean finding the right doc, having surgery, recovering, and trying to set speed records for it all.  Shooting for the Guinness Book.  For me that’s the interesting part of the story.  It was something I could DO, something I had control over.  It was time for CancerKMA (that’s right: Cancer – kiss…my…ass!).

Steve

Murder In Mind at Amazon

Murder In Mind at Barnes & Noble

A Twisted Path at Amazon

A Twisted Path at Barnes & Noble

Quick recap: too much exercise leads to a kidney stone that instigates an exam that reveals cancer that would have remained undiscovered if chance and the universe hadn’t intervened.  On tonight’s episode, which is a little anticlimactic because we already know the protagonist isn’t going to die, we follow his escapades.

I’m having a chat with Dr. XXXX.  What are my options?  What’s the recovery rate?  Does it return/metastasize/lurk for years?  I’m hungry for data, because that’s how I do it in the real (non-cancer) world so why should this be any different?

Dr. XXXX only performs the traditional surgery – slice open your belly (“belly” is a little diplomatic) and cut out the prostate.  In the old days, they’d cut right through the nerves the prostate rests on.  Those nerves are…important.  VERY important.  Nowadays, they engage in “nerve sparing” surgery.  That means instead of just buzz-cutting through the nerves, they try to gently remove the offending organ while leaving the nerves intact.  Like peeling a soft-boiled egg out of a shell.  Sometimes that goes really well.  Other times, you get shreds and yolk and a lousy breakfast.

The main problem with the traditional surgery is the recovery time.  Weeks and weeks, because a big, wide slash through muscle doesn’t heal overnight.

“HOW long did you say I’d have to stop working out???”

Dr. XXXX describes a second approach.  “A few years ago, a machine called the Da Vinci became popular.  It makes a series of smaller incisions and the surgeon operates robotic arms to remove the prostate.”

I’m picturing Tom Hanks and some crazy albino guy hunched over me in the operating room (Da Vinci Code?).  But I’m in, because smaller cuts means faster recovery.  Buh-bye, Dr. XXXX.

Good news: City of Hope is one of the top cancer hospitals in the country and is under an hour from my home.  More good news: One of the best urology oncologists with vast amounts of Da Vinci experience is there.  Bad news: The hospital is full of people who have real, deadly, how-long-am-I-going-to-live cancer.  Not my wussy little one-organ cancer, the kind that hasn’t spread and is totally treatable.  Still, I’m fortunate to be part of this exclusive club of people getting extraordinary treatment from the best in the biz.

On my way out to COH I notice a small sign on a post.  Simple, unobtrusive, guiding, it says City of Hope.  This doesn’t qualify for Funny Thing #4, but for the first time, I get a little emotional.   Just a lump in my throat and that misty feeling you get in your eyes when you see your kids do something unexpected and loving, or when there’s a touching scene in an otherwise stupid movie and you weren’t expecting to be moved.  I let it wash over me, blinking a little, and maybe because I give it its due it goes away.

Free valet parking at the cancer hospital on your first visit.  Very cool.  I’m Platinum at Starwood hotels and don’t get free valet parking.

The hospital processes me efficiently and quickly.  This isn’t their first time at the dance.  Blood, vitals, etc.  Then I meet with Dr. Kawachi, renowned fixer/genius/Mother Teresa/real Da Vinci of prostate cancer.  I’m not sure what I was expecting, but he didn’t match it.  Sweet, gentle, almost wizened man.  Soothing voice, matter-of-fact and a listener.  I start asking him questions – standard recovery time, ways to minimize recuperation, angle of entry of the blades on the Da Vinci.  His tone doesn’t change, his demeanor remains gentle, open, helpful.  He drops any hint of needing to hold my hand and assuage me.  He goes along with me as I do what I do – gather data.

“Let me tell you a couple things so you understand.  I want the fastest possible recovery – anything you can do toward that, do it.”

We have a very clear conversation.  No BS.

“Well, if I make the extraction incision a little lower than usual, I won’t cut as much muscle.  That should help.”

I like this guy.

“I trust your judgment to do what works, and to balance that with the fact that I plan on breaking records to recover.”

We talk about typical recovery times – a couple weeks off of work, longer before I can work out.

“Nope.  That’s too long.”

He smiles.  I smile.  We set a date for the surgery.  It’s soon – the cancer keeps knocking at the door.

A couple weeks later, I go back to COH.  Dr. Kawachi’s only flaw: he does surgery on Friday, not Saturday, so I have to take a day off of work.  Early in the morning they’re prepping me.  The anesthesiologist reads my note where I explicitly tell him to use the minimum amount of drugs necessary to keep me under (that stuff stays in your system – I don’t want to have to deal with the extra time!) and promptly labels me (silently) a pain in the ass.

A couple hours later I wake up.  A little sore.  Turns out the Da Vinci truly is a work of art.  I look down at my “belly”.  Seven incisions, all an inch or smaller.  One for the light , another for the knife, another for the grabber to rip my prostate out, and a couple for…I don’t know, alien probes.

Then I look up and my ex-wife is sitting there.  I assure her I am alive and the life insurance will not be paying out yet.  Her disappointment is palpable (okay, quick confession: that last bit is silliness.  My ex-wife – let’s call her “Robin” – is one of the best people I know.  We amicably co-parent and she remains my emergency contact, and vice versa).

Dr. Kawachi stops by.  We have a little chat.

“It’s good if you can get up at some point today and walk around a little.”  He puts his hand out as I reach to lace up my running shoes.  “Just a little walking around the hospital.”

Then we get down to business.

“How aggressively can I push recovery?”  In fact, I ask half a dozen questions along these lines just to make sure he knows what I’m saying.

His answer is perfect: “Pain is your guide.  You won’t do any damage if you use pain as your measure.”

Did I mention I like this guy?

I take a couple dozen strolls around the hospital and I’m ready to go home.  My pal Christine – who is more familiar with cancer than anyone should ever have to be – is there along with Robin.  They’re going to drive me home – hospital rules.  Fat chance.  I’ll drive.

One complication: following my little surgery, I notice there is a hose attached to my “nether regions”.  It is a catheter.  If you don’t know what that is, I’m very happy for you.  One of the reasons they don’t want you to drive yourself home, aside from the obvious, is they are concerned you might have to slam the breaks on and in the lurching of the car, rip out your catheter.  If you think a prostate exam is invasive, yanking out your catheter makes it look like a holiday.

I don’t plan on slamming on the breaks.  After some negotiation with Robin and Christine (and some subterfuge [lying] to the hospital staff) I agree to permit Christine to ride in the passenger seat in case I pass out.  We make it home safely.

Time for another break…Part Three below.

Steve

Murder In Mind at Amazon

Murder In Mind at Barnes & Noble

A Twisted Path at Amazon

A Twisted Path at Barnes & Noble

Surgery was yesterday, Friday.  Today it’s Saturday and I’ve driven myself home.  And I have the kids on Saturdays (and Tuesdays and Thursdays and…) and no catheter and bag or swollen incisions or cancer-free innards is going to keep me from my kids.  Besides, let them take care of me for a change!  (Digression #2 – that’s also silliness.  They are loving, caring, respectful, independent, attentive – oh, and brilliant, beautiful and…still, let ’em take care of me tonight!).  The night goes well though I must confess that peeing in a bag is bothersome.

The next day they go to their mom’s.  I look at my stationary bike.  I look at the hose-and-bag situation.  I do some quick calculations.  Five minutes later I’m on the bike with a chair next to me serving as “coat rack” for the catheter bag.  Feels pretty good.  Next day I go to work – wearing my “cancer pants” – a pair of black track pants.  They slip up over my swollen middle and allow me to strap my bag to my leg.

Only a couple people at work know about my weekend adventure.  One of them sees me at work and says “didn’t you have…” and then just rolls her eyes.

Time out: this again sounds like I’m a little blase.  I’m not.  I’m just a data hound.  If something hurts but is not doing damage, then it is your choice whether to do it or not.  And if it doesn’t hurt, then there’s no reason not to do it.  Exercise, work, etc – I’m following the doctor’s recommendation and letting the pain measure what I can do.   Standards aren’t rules.

Here’s a very cool thing – COH has a twenty-four hour on-call nurse.  You ring any time day or night and she’ll answer or get right back to you.  A couple days after the surgery, I notice that an area of my body that is usually not pitch black suddenly is.  I am slightly alarmed.  It’s 2 a.m.  I call the nurse. Margaret answers.  She sounds experienced.

“Honey, I’ve seen ’em be yellow, black, red, purple…you’re fine.  Don’t need to worry unless it hurts a lot.”

My relief is palpable.

A week later I pop into the hospital to have my catheter removed.  It is an interesting sequence of events.  Everyone handles it differently.  The nurse explains the process, tells me it will be fine, attempts to be soothing, and I give her a short version of the same speech I gave Dr. Kawachi.  She’s a pro – twenty seconds later we’re done and she practically hugs me; there’s a guy in the next room who’s been there for two hours and I think she’s ready to order valium.

There are two major side effects of having a prostatectomy (fancy word for the slash-and-grab  that took the organ central to the ability to reproduce.  Quick side note: I made a “deposit” at the cryogenic lab before my surgery.   Just in case I need to make some more stunning children).  The side effects are a result of the fact they are re-doing your internal plumbing.  Things that were attached one way are now attached another way.  And, as mentioned earlier, nerves are traumatized.  So what are these two common side effects?  Trying to think of some delicate euphemisms here…Never mind, here goes.

Incontinence and erectile dysfunction.   NEITHER is a friend.

Going for delicacy at this point.  By thirty days after the surgery the former was nothing more than a memory.  On the other hand, re-invigorating those poor traumatized nerves that wanted to go into hiding for the rest of my life was a different matter.  Standard treatment: a year of daily Viagra to remind the guys what a normal response is.  My response: No.  Freakin’.  Way.

So I begin a…”regimen.”  I record it (in writing and in code, of course – so my kids don’t come across down the road.    On my first visit to Dr. Kawachi six weeks after the surgery, I show it to him.  He is quiet for a moment.

“That’s very interesting.”

Fast forward three months.  I take my first PSA test.  If there are detectable levels of PSA in the first year, it is a very bad sign.  My first test comes back “undetectable.”  I continue my recovery.  Three more months, then a year after surgery – still nothing.

It’s now been two years.  I get the PSA test done on schedule, more or less.  Physically, all is good.  Emotionally, all is good.  Spiritually?  My life did not change, I did not suddenly go sky-diving or look at the sunrise with fresh eyes.  I did not wake up and realize life is fragile and I have to grab every moment.  I already knew all that.  For fifteen years, every single day I’ve looked at my kids and said some version of “I can’t believe I’m lucky enough to have them.”  Before cancer, I grumbled about work or bad drivers or why I wasn’t writing enough.  After cancer, I do all the same things.  But I also loved my life before cancer and I love it now.  Before cancer I questioned my choices, made fun of myself, wondered if I were moving through the world with too much of a sense of entitlement and ownership; after cancer I do the same things.  There are things I like about myself and plenty I don’t.  That was true before and after cancer.

What I didn’t know before cancer, though, was something I couldn’t have learned without it: that my view of the world is consistent, that I am who I think I am.  I don’t know if that is good or bad.  I just know it is real, and it is somehow comforting.  Wait, that’s not the word – it isn’t comforting.  It is…refreshing.  Encouraging.  Interesting.  And maybe just a little disconcerting.

So at some level I suppose I should thank cancer for the experience.  For the insight.  For the – “side effects.”  But I’m putting all that aside.  Instead, the only message I have for cancer is: Kiss My Ass.

Steve

Murder In Mind at Amazon

Murder In Mind at Barnes & Noble

A Twisted Path at Amazon

A Twisted Path at Barnes & Noble