Why I Left

On Palm Sunday, 3/28/2010, my stepfather died of brain cancer. The week before, my friend's mother died of complications associated with lymphoma and heart failure. The following week, our buddy Jo died of pancreatic cancer. It was just too much illness and death from cancer to leave my coping mechanisms untouched. I felt myself getting pulled further and further under water with each of their last days. I wanted to feel lucky to be alive, to have emerged from my own two bouts of cancer, but I couldn't muster it. My mood slipped lower and lower, sinking me into a panicky, worried state. Several days later, I attended a medical conference on the H1N1 or swine flu. The researcher presented information on the number of cases recorded in the state with information on the number of deaths from the virus. Three people died in the Duke Bone Marrow unit where I received my Leukemia treatment from June until November of 2006. That just hit too close to home. Had it been different timing, it could have been me dying of the flu when my immune system was obliterated by my chemo. Had it been different timing, it could have been me who was treated with Tamiflu, only to discover that my virus was resistant. Had it been different timing, it could have been me they intubated when my lungs stopped exchanging oxygen. No, it wasn't me, but I became more anxious and unhinged anyway.

Then I had my own health scare when one of my cell counts fell a bit below normal during one of my routine blood draws. It sent me over the edge. I couldn't concentrate at work or at home. I couldn't relax without worrying that the numbers were evidence that my leukemia was coming back. I fretted through 3 weeks of sadness and a whole new round of "what ifs?" Then I had my blood drawn again. My counts were back to normal. It was just a hiccup. I'd love to say that I found a way to control my emotions and all of the negative thoughts, the worries, but I didn't. My counts just came back to normal, and my mood improved. Hallelujah!

That's where I went for a while.

Happy Birthday to me...48th today.

Losing My Way

Last Friday I got a message on my cell phone from a police officer who asked me to call her about a subpoena. I guessed that one of my patients had stolen or forged a prescription. The policewoman informed me that I was being subpoena'd by an attorney in Asheville who needed me to testify in the criminal case of a former patient. The attorney had actually called me two weeks prior to ASK me if I'd be a witness for his client, someone who had been accused in a sex abuse case. The attorney hoped to refute the sex abuse allegations with my testimony verifying that his blood pressure medications made him sexually impotent. I refused to testify in his case, so he had me subpoena'd to compel me to testify. Usually I would be only irritated by such a maneuver. But I really lost my way on this one. My family has had plans to vacation at the beach with my newly widowed mother for months. Each year, my mother rents a wonderful place at the beach during the week of my birthday. This year, after all of the stress associated with my stepfather's diagnosis and subsequent death from brain cancer, we have been particularly looking forward to our week at the beach. I explained to the lawyer that I had a week of vacation with my family planned for the week of his trial. He explained that the court proceedings in this criminal case in Superior Court would take precedent over my vacation. (As my friend who is a lawyer explained-"the court doesn't care if you have vacation since your testimony may decide whether someone goes to jail ..."). I have to say, I came undone by this whole episode, which seemed like such an unfair travesty. I did not want to testify for this creep, and I resented the jerk of a lawyer for serving me with a subpoena that would potentially wreck my vacation unless he found another MD from my former clinic to testify.

I am ashamed to say that I focused entirely too much on the potential loss of my vacation with this inconvenient timing. I was in an "ill mood" as my grandmother used to call it, for most of the weekend and the early part of the workweek. I found it hard to focus on anything other than my anger. I kept telling myself that I needed to relax and let it go. I was letting it control me. And then I realized this whole episode for me was about control. Apparently, I have to keep learning this same lesson over and over again.

When I had cancer the first time, I realized that we are all going along, living our lives, just under the illusion that we are in control. I got through that tough, tough 6 mos of treatment, happy to emerge from the other side no worse for the experience. I went back to work, my hair grew back, and I moved on. When I got cancer the second time, as a result of the chemo and radiation used to treat the 1st cancer, I got that slap in the face again. It's as if the universe was saying (again), "You are not in control." Oh man, how many times am I going to learn and relearn and relearn this one? I mean encore un fois over again...
Sooooo, here I was realizing, encore un fois, that I am not in control. If the Superior Court of Buncombe County tries to subpoena me to testify in this case, who I am I to say that I won't be there-vacation or no. When I finally came to that realization, and let it go, my moodiness lifted. I felt so much happier. I wasn't ill or angry or resentful anymore. The next morning, I telephoned the lawyer and surprisingly was told that I didn't have to appear. He'd found another MD to testify in my stead.

What's the life lesson here? I lost my way because I thought I could control something that I couldn't. We all delude ourselves like this each and every day. Maybe it helps us somewhat. It can be paralyzing to think that whatever you do or plan can be readily undone by the universe. Here's what I took from it: I spent so much time being angry and upset, fretting about what would happen if I "lost" my vacation, that I lost 4 or 5 days to that funk. I'll never get that time back. And unlike most people, I actually am aware that our time here is precious. I squandered some of mine on something that didn't matter, really. Thankfully, when I let it go, I got good news, and I am now writing this from the beach. Hopefully, I'll be smarter next time.

Forever and a Day

I have been reluctant to write for quite some time, trying to deal with all of the life events of friends and family. On Palm Sunday about 9am, my mother became a widow. Brian's death did not come as a surprise, of course, since he had been diagnosed with an aggressive brain cancer in September of 2009. But he seemed to do well with the surgery, chemo and radiation, and was at least, holding his own until the cancer returned around Christmastime. He never really recovered from the second major surgery- marked by one mishap after another-a head bleed, leakage of spinal fluid from his ear, delirium, a stroke that left him with poor strength on his right side, and then countless hours of rehab, followed by a restless course at home with hospice care. The end is never easy, and his wasn't either as my mom and his son, Vernon, struggled with him until his placement in the hospice facility in Mt. Pleasant. Even the last little bit dragged on more than usual, until Palm Sunday when he passed away just before 9 am.

We had a church memorial for him that Wednesday followed by the scattering of his ashes off the dock at their house. The service was terrific with Father Charlie, their former minister, doing the eulogy. Charlie had know Brian and my mother for a long time, and he really conveyed that familiarity in his remarks. The memorial included a full church service, something that I think Brian would have really liked. The scattering of the ashes involved just family-all of us huddled together on the dock, at extremely low tide, watching his dust scatter in the wind and water. Amazing that such a big guy is reduced to not much more than a gallon sized bag of ashes and bits of bone after cremation. I scooped a big handful of the gray dust and bone shards to feel him between my fingers for the last time- a welcome relief after all of the words and feelings that had been swirling about all day. The wind took some of the dust into that shallow water and mud and blew some of it onto my pants leg and the dock surface. It felt so good to have a bit of bone in my handful and get to feel something solid. But that is just the way we are, isn't it, holding onto solid forms for as long as we can. I was so glad that we could scatter Brian's ashes exactly where he wanted to be-the very place he most loved in the world. It makes me tear up even now to think about how sweet that was. How it made me feel part of something bigger than myself, than any of us. What a delight to share all of that community and fellowship in Brian's honor. I know that I was not the saddest person there that day, but I had my own special reasons for being sad and touched and fortunate to be there as a LIVING being, given all I have been through with my own cancers. It makes me all the more grateful and pleased to be here.

Happy St. Patrick's Day

I'm pretty sure my Irish ancestors somewhere would be proud of the 10K run we did as a benefit in Asheville this past w-e. Lots of people were dressed up, in lots of green, for the Shamrock run, which proved to be a challenging 6 miler up and over quite a few hills in our area of town. It threatened to rain but held off, giving us a beautiful day to enjoy the views from Sunset Mtn Rd toward downtown and the mtn range west of town. As one woman said to me as we were finally, finally crested the top of the biggest hill, "Well we worked for that view." Yes, we did. Holly and I rewarded ourselves on the way home with some delicious treats from the Sisters McMullen bakery which has just relocated (again) to another spot on Merrimon Ave-our part of town. We knew them when they still made doughnuts (now left to Dunkin D, just not enough profit in those...) and were located just around the corner from us. Now they specialize in cakes and more traditional bakery treats. Just fine by me, as they're all good and yummy.

Wear green today, pick up a shamrock, and spread some good luck today. Happy St Patrick's Day!

A Gaelic Blessing

Deep peace of the running wave to you,
Deep peace of the flowing air to you,
Deep peace of the quiet earth to you,
Deep peace of the shining stars to you,
Deep peace of the gentle night to you,

Moon and stars pour their healing light on you,
Deep peace of Christ, the light of the world.
(from a stone inscription at the Bald Head Island, NC chapel)

A Wonderful Day So Far

I have been remiss in catching up here lately. As I have said before, I feel a bit sheepish about continuing to post my writing here, now being so far from all of the original reasons to start this thing in the first place. While I will never forget that time of uncertainty and worry over my (then new) diagnosis of leukemia, I have moved on. Sure I get a monthly reminder of all of that seriousness when I have my blood counts done, but the steady, normal counts quickly push away any worries I might have. I would never say that all of this happened for a reason (unless you count weak DNA repair systems) or that I am better off because of it, but I can take pleasure, still, in the simplest things. As my girlfriend was leaving for work this morning, she wished me a good morning. I work the late clinic on Monday nights, a hellishly long 12 hour day that I never look forward to-e.g. I saw 36 patients yesterday. However, my recompense is Tuesday mornings to myself, with only half a work day. So I was sitting on the edge of the bed looking at the trees just starting to bud, with daffodils I had planted blooming at their bases, while a myriad of birds sampled our feeders. I was sipping a delicious cup of French Roast coffee and thinking about my run to Ayr Mount, my usual run destination on Tuesdays and Thursdays. As Holly wished me a good morning, I replied that it had already been wonderful so far. Can you imagine how terrific it feels to sit in a warm, sunny spot where you can watch birds, flowers, trees, and drink coffee in a leisurely fashion? Can you imagine getting to do that every week-not having to set an alarm clock or rush out the door to meet your first patient of the day? Honestly, it has been a wonderful day so far...

This past w-e, Holly and I rode the ferry to Bald Head Island to join our friends Marty and Debbie at their new beach house just south of Wilmington. They have a big old place hidden amongst the moss covered oaks that they share with 12 other couples, each of whom gets the house for a week per season (13 couples x 4 weeks/couple =52 weeks). This is the spring week for Marty and Deb, who so graciously allowed 8 of us to join them. We had a terrific w-e there too, running the trails along the beach, visiting the Nature conservancy and Old Baldy lighthouse, enjoying seafood and other meals together (thanks Deb for that fabulous fried shrimp dinner-my favorite!), and watching a few basketball games as a group. As there starts to be some cross pollination between our friends in Asheville and our friends in Durham, Susan and Donna were along for the w-e too. Marty and Deb joined us in Asheville at Thanksgiving last year, and invited Susan and Donna to meet them at the new beach house sometime. So it was really a delight to have so many of our friends from both communities with us to enjoy that special place. I can't wait to see Susan's pictures of the island, being the photojournalist that she is. I'll make do here with a few photos from my little camera, just to commemorate the trip.

Almost March

I realized yesterday that March is next Monday. Perhaps this does not come as a surprise to anyone else, but it did to me. I was doing the yearly physical exam on one of my female patients, going over the preventive things we need to address for her health. I made the comment that when she turns 40, I want to order her mammogram. She pointed out that her 40th birthday is March 1st, this upcoming Monday. Wow! Already! Great news. Somehow, I've been mired in February and winter in my mind-
seems like f-o-r-e-v-e-r.

After my run this morning I was filling the bird feeders, cleaning up the trees that had been blown over by all of the recent snow, and trimming some of the dead stalks from my perennials. Upon closer inspection, I noticed that the perennials are gearing up with new green shoots and leaves. I hadn't noticed any of that from my bedroom window, but at ground level, it is quite obvious. Fabulous to see spring just around the corner.

I spent this past w-e in Charleston with my Mom. She had fallen on her face last week, just one more thing for her to deal with during this difficult time. My stepdad hasn't been doing very well in the Rehab facility where they moved him after his latest brain surgery. However, things progressed some this w-e for both of them. My Mom's face is getting better slowly with less swelling and bruising everyday. She can drive again and even walked with me Sunday for exercise (getting her Teresa points as she calls it). And, we were able to get Brian up to sit outside, visit with their dog Dixie, converse with visitors, eat on his own, and walk (assisted) to the bathroom and shower. I am hoping that he has turned the corner and will be able to do more and more as he regains his strength. I know that eventually his brain tumor will come back-it's an aggressive bastard-but my hope is that he can go home before any of that happens.

I was struck by how odd it feels to help dress and bathe and walk with Brian. I had my own hospital days not so long ago with lukewarm showers and hospital food and interminable hours in my own little room. I was weak too, especially after that 7 day course of continuous chemo to get into remission from the leukemia. I too, could barely walk on my own, fatigued even by the act of eating. Amazing to think that without those tough times, I wouldn't be here. Boy am I glad I persevered through that and more to be here today to run through Ayr Mount park as I did this morning, to get to see all of the woodpeckers at my feeders as I write this, and to notice all of the green shoots coming up where I trimmed away the old dead stuff. That, to me, is the perfect morning, as we barrel towards March now.