Summer                                                                   Healing Moon

Today is my pre-op/post-op consultation with Dr. Eigner’s physician’s assistant, Ann. She’ll go over what I need to do for surgery prep, what we can expect during the surgery and immediately after, then give us post-op instructions. My level of comfort with all this is substantially higher with Kate involved, both because she’ll be there to hear what I miss and because her own skills make her over-qualified to help me before and after surgery.

I continue to sleep well, have no symptoms (none expected, but still good). Since we are now 10 days out, I’ve stopped my aspirin. My feelings have become more labile as the surgery approaches, which makes sense to me.

The surgery itself has a paradoxical quality, as I imagine many such surgeries do. The paradox is this. It offers me real hope, an opportunity to continue my third phase cancer free. And, that, of course, is the reason for the surgery. On the other hand it has attendant pain and discomfort, improbable but possible complications.

It also might reveal that the cancer is worse than we imagine.  My staging included the seemingly innocent, NxMx. The N refers to the status of the lymph nodes near the prostate and the M refers to possible metastasis, or the spread of the cancer to the rest of the body. The x means unknown.

This is where the paradox becomes strong, intense. The surgery might (probably will) move me past this whole episode. In that case, hallelujah. Or, it might dash that hope and begin another series of tests and treatments. In that case, uh-oh.

The good news is that if Eigner had suspected lymph node or metastatic involvement he would have ordered imaging studies prior to surgery. He didn’t. That’s a positive sign, but only that. We won’t know until the surgery is over, perhaps not even then. We may have to wait on the pathology report, or even the first few p.s.a readings in the year + after surgery.

My emotions ride along the trajectory of which outcome dominates my mood. Most of the time I imagine negative margins on the removed prostate. That means no cancer cells in the tissue surrounding the removed organ. Not definite relative to NxMx, but very positive. Occasionally my rational side will bring me up short while I’m feeling good about this most likely outcome. Wait, it says. You might be right, but what if you’re wrong. Then, you’re feelings will fall from the height of hope to the canyon of uncertainty. Oh. Right.

When rationality moves me to consider all the possible outcomes, then I can slip into fear. One problem with an active imagination (7 novels and one underway) is that I have no difficulty following the path of more tests, more treatment all the way to death. The first feeling that comes in the wake of that thought is fear.

I’ve worked out over the last 50 or so years, a philosophical position that calms me before the fear dominates and shakes my foundations. Usually. Nothing’s 100 percent. I’ve expressed it elsewhere. The short version is: something, some time. It’s buttressed too by my belief that life is the mystery, death is ordinary. And those rocks around Turkey Creek and Deer Creek Canyon roads. The ones that have been here so much longer than I’ve been alive and will be here so much longer after I die.