New workout with Deb. A lighter pace on cardio, less reps. Still challenging. Dave, Deb’s husband and partner at OMTF, had a recurrence of his brain cancer not long after my psa began to rise. He’s had brain surgery already to remove the tumor. Chemo for a year.
But, and here’s the world I inhabit now, they chose against radiation. Why? First, it’s radiation to the head. The brain. Yikes. Second, Dave’s neurosurgeon told them cognitive decline was a possible side effect. Can you imagine having to choose between a future recurrence after a recent return of the cancer, and less mental acuity? Dave’s probably late 50’s.
Poster designed by JUMP
These are real life conundrums, made when disease creeps across the nuisance threshold into the realm of life or death. Underlined one of the weird good fortunes I have. The prostate is next to the bladder and the lower bowels, but the cyberknife accounts for that because there’s so much space.
In radiation for breast cancer the heart and the lungs are in potential danger. In brain cancer, well… My cancer has a physical location that doesn’t present those sorts of obstacles for radiation.
Cancer and other potentially fatal diseases focus the mind. This is the top priority for now. I chose to bracket summer this year in favor of repeated trips to Lone Tree, about an hour away. I chose to further bracket the next 6 to 12 months by saying yes to Lupron therapy. The daily radiation regimen will fall away on August 6th when I will have assembled all the fractions into one, delivered in 35 bits. But Lupron will continue.
Listened to Carol King yesterday. Too thin. Back to the more substantial gruel of Renaissance Music.
My friend Rich sees mussar as a metaphysical, not a psychological discipline. It’s soul work, deeper and more consequential than therapy.
Over the last year and a half my skeptical view of soul has begun to break up, fade away. First, from the Cosmos and Psyche (thanks, Tom) insight: Skepticism is a tool, not a lifestyle. Second, from a spiritual realization that despite its implication in the arguments over, say, original sin, soul nonetheless points to a felt reality for me, a phenomenological knowing. Not a dogmatic or doctrinal one.
Big deal, right? You always knew this? Or, no way, dude. Either way, so what?
And, of course, you’re right if you follow this often used, little understood idea back to its sources in Judaeo-Christian thought. Its use either assumed-you always knew this, or, so mean and inhuman, eternal hell for a few years on earth-no way, dude.
The Judaeo-Christian understanding incorporated the Greek notion of psyche, “…the mental abilities of a living being: reason, character, feeling, consciousness, memory, perception, thinking” with a notion of immortality connected to behavior in this life.
I want to push back, back beyond this narrow conception of soul. There was an assumption among the ancient Greeks that soul had to have a logical faculty, and, that it was the most divine attribute of a human soul. ( The current scientific consensus across all fields is that there is no evidence for the existence of any kind of soul in the traditional sense. Wiki.)
First I want to speak for the trees. Let’s call it the Loraxian understanding of the soul. The lodgepoles in our yard, crawling up Black Mountain, growing along Brook Forest Drive as it winds down the mountain. They have souls. They are both alive and animate, creatures with a telos, or end goal. They interact with their environment and grow strong or weak, tall or short, but they remain lodgpole pines, trees with a particular role in a montane ecosystem, a role which they give all they have to fulfill.
The same is true for the mule deer, the mountain lion, the marsh marigold, the elk, the bear, the fox, the squirrel, the dandelion, the cheatgrass, the Indian paintbrush, the mountain trout, the raven and the magpie. Are their souls more or less than ours? Wrong question. Are their souls more like ours or more unlike? Don’t know. I just know that living things on the planet share the wonder of life, an independent spark. That spark gives us organic matter that moves and does so with intention.
Holy Well, Wales, St Dynfog
I’ve felt this way about the world for a long, long time. Taoism, Emerson, the Romantics, gardening, the Celtic Great Wheel. The mystical moment on the quad at Ball State. Oneness. With it all. I’m even willing to entertain faeries, elves, duendes, daiads, Gods and Goddesses. OK, I know I lost a lot of you with that one, but I’m going with my gut, my revelation to me rather than the dry dusty bones of theirs.
But. I want to push one step further. I believe in the spirits of the mountains. They have visited me here on Shadow Mountain, the mule deer on Samain, 2014, and the elk on my first day of radiation. The mule deer and the elk were angels, that is, messengers of the mountain gods, dispatched by the careful, slow, deliberate entities that are the Rocky Mountains.
I believe in the vitality of rushing water in Maxwell Creek, Cub Creek, Blue Creek, Bear Creek, the North Fork of the South Platte. I believe in the entity that is Lake Superior, that is the great deposit of ores on the Minnesota Iron Range, the ebb and flow of the Oglalla Aquifer.
I believe in Mother Earth, the great Gaia, a living system of ecosystems, biomes watered by rains and the snows, irrigated by streams and rivers, planted by Boreas and Zephryus, and given power to change by the true god, Sol.
Neither animals nor plants can grow without the sun’s energy or the food locked in minerals and vitamin: “Our soils support 95 percent of all food production, and by 2060, our soils will be asked to give us as much food as we have consumed in the last 500 years. They filter our water. They are one of our most cost-effective reservoirs for sequestering carbon. They are our foundation for biodiversity. And they are vibrantly alive, teeming with 10,000 pounds of biological life in every acre. Yet in the last 150 years, we’ve lost half of the basic building block that makes soil productive.” Living Soil film
As it appears, I am an animist, a pagan, a person who has found his spot in the great scheme. I’m a moving instance of matter formed in the great fusion furnaces of stars. I’m a temporary instance, holding together a few atoms for a human lifetime. I’m a significant instance of meaning created by the universe observing itself, throughout my short path, as the dynamic, interlocked, soulful reality that it is.
I need no human word to guide me. I need no idea, no rule. I am and I am within all this. The Arapaho National Forest. The Rocky Mountains. Our nuclear family. Our extended family. The community of folks at CBE. The United States. The Mind of God.
My soul and that of Kepler, Rigel, and Gertie dance with each other. In Andover Kate and I danced with bees, fruit trees, perennial flowers, vegetables, raspberry canes. Here we dance with the mountain spirits.
Long ago I set out on a spiritual journey that went down and in rather than up and out. That is, I would not find validation somewhere outside of myself whether Torah, Gospel, Constitution, or political ideology. I would not privilege the idea of transcendence, or a three-story universe. No god is in heaven, and yet all’s right with the world. My ancient spiritual trail has been to turn within for the source of my revelation. And, I have not turned back.
18 fractions absorbed. 180 minutes, exactly three hours under the watchful iris of the Cyber Knife. Roughly 3500 cGys of the total 7000 cGy* prescription. This is over half-way. 18/35ths.
Hard to separate out causality. Does my occasional fatigue come from the radiation? The Lupron? Indolence? What’s causing my crampy stomach, over eager bowels? Are those prickly hot feelings transient hot flashes trying to break through? Or, are all of these some crummy bug that came along at a time when there were multiple possible causes? Not sure.
This weekend respite is very, very welcome. I need some time to relax. Decompress. Gather myself again. Three weeks plus a couple of days before all 7000 cGys are in place. A marathon, not a sprint.
Ruth and Gabe are here. Ruth mowed the fuel yesterday. Gabe picked up the detritus of Rigel’s bunny lust fueled attack on our back deck. They picked flowers for us among them Columbines and Daisies. Kate cut two of our blooming iris. Maroon bearded. Have not bloomed the last couple of years.
Another Great Wheel consolation. The iris will bloom. The daisy’s, too. Lodgepole pines will release their pollen in June. The mountain streams will race as soon as the snowpack melts. The elk rut will send the strangled bugling of the bull’s out into the fall air. Snow will fall in December. Rain will come on July afternoons. The altitude on Shadow Mountain will keep a cool gap open between temperatures down the hill and those up here. Long after we’re all dead. Oh, yes, over a long time even these things will change in some way, but the cycle of the natural world to which death belongs will continue.
* ( a unit of absorbed radiation dose equal to one hundredth (10−2) of a gray, or 1 radFreeDictionary)
Looks like the ride’s going to have turbulence. I feel much better than I did Sunday and Monday, but I still have a jangly feeling, my stomach has become unpredictable, and my bowels want complete and rapid elimination of any thing I throw down there. Also, fatigue. I feel tired, the muscles of my legs communicating exhaustion, with no noticeable activity to explain it.
There is good news. Ignoring the fatigue I got on the treadmill yesterday, did fifteen minutes instead of twenty, but moved right on through my whole workout. Slighter lower weights at some points, but mostly right where I’ve been. Felt fine afterwards. The fatigue is, to some extent then, a mirage. At least now.
Plucked my radiation hazard tee out of the dryer, put it on with my new Amazon basic’s gray sweats, tossed the electronic key in my pocket, pressed the button on Ruby (as Kate calls our red Rav4) to start her up. Two bottles of water by my side I headed down Shadow Mountain Drive to 285.
The drive remains the most challenging part. Due to the heavy construction not only are there lane shifts, concrete barriers, and oddly placed entrance lanes, but dump trucks, trucks for carrying loads of soil, the occasional piece of heavy equipment. The car and SUV crowd, like me, seems divided between those who follow the 55 mph speed limit and those who can’t be bothered. The result is lane weaving, brakes, slow downs, speed ups. About 14 miles worth.
With the fatigue my only real desire when I’m done is to drive the gauntlet going the other way, get home, and go to bed. Not sure whether this will be the new normal, whether it will get worse, or better. Better in the distant future, I think.
Cancer’s negative affects on me have all, so far, come from treatment. The surgery and post-op recovery. The Lupron. Weekday radiation treatments. Which is weird if you consider it. Cancer. But, no symptoms I can feel. Treatment and side effects that I can.
Zoom, zoom. Zoom. From the land of First Light to the top of Shadow Mountain, two in the land of sky blue waters. Friends. Bytes and pixels. Sight and sound. Remember when video phones were still a thing of the future, the distant future? We knew somebody from Bell Labs would create them, but when?
Still no flying cars, but there are multiple instances of the video phone. Zoom and Skype, for sure. Kakao, which allows full on video calling. I know there are others I haven’t used.
These forms resolve one of my problems with the old, voice only phone. No facial expressions. No interaction of a bodily nature except for vocal cords and the ear. Too thin for me.
We spoke of gum and sealing wax and other fancy things. Laughed. Nodded when we gave our ideas about patriotism. Complicated, as Mark said. Mostly we reaffirmed our friendship, saw each other in body and soul. A fine thing to do on a Sunday morning. The church of friendship.
In trying to get back to full bowel readiness for the 4th chapter of the Radiation Tales I went too far. Body rebelled. Nausea. (OMG! Is this a side effect? God I hope not.) Finding the balance for preparations is not easy. Pretty sure I brought this one on myself. In bed early with no supper. Stomach still ouchy this morning. Insulted.
It’s a beautiful day in the neighborhood. Expect to hear Mr. Roger’s, “Won’t you be my neighbor!” Toot, toot of the train.
Back to the beano. Radiation vacation is over. Put away the seltzer water. Chapter four of the photon chronicles starts tomorrow. Now it’s every day till the finish.
Still in the tunnel. Moving deliberately, neither slow nor fast. Holding in my heart this saying. My commitment is to the process. Yes, I hope it’s curative; but, it’s the route I’ve chosen and that is enough.
I’m grateful to the whole chain of folks involved in my care. Eigner and Willis for getting me quickly to Anova. Gilroy for a treatment plan. Nicky, Kim, and Patty for their kindness and care. Carmela for her brightness. Amanda for taking my need to make progress seriously. Kate for listening as I offer some new fact I’ve learned or a skewed feeling, for her own recovery. Alan and his steadiness. CBE for multiple mitzvahs. Shelley for the Lupron. Even Nari for his help with the new car.
And of course there are the folks I’ll never see. Fermi. Einstein. Nuclear engineers. Medical engineers. The dosist. The medical physicist. Inventor of the Cyber Knife. That train of thinkers and tinkerers who developed this particular instrument.
Yes, under the radiation moon, I will almost complete my treatments. They will end on August 6th and the new moon is August 1st. By then I’ll have an idea of what, if any, side effects radiation will bring. The new moon I’m going to call the Lupron moon because I should be well into the period when ADT might start causing side effects.
I had a brief scary moment while I did my workout this morning. Over the last couple of weeks two dementia related cautions have appeared in the press. The first, about anticholinergic drugs said users of these drugs faced a 5% increased risk of dementia. I’ve been on tizanidine for three years. It’s a muscle relaxant I used because my left shoulder had become painful. I stopped taking it.
The second caution was about ADT, androgen deprivation therapy. That’s the Lupron. I’ve focused, as I’m sure most do, on the side effects that can come with the drug right away: bone softening, mood changes, hot flashes among others. It’s a little confusing about the dementia/Alzheimer risk, but it seems 12 months of ADT can increase the risk of dementia by as much as 20%. That’s a lot.
The scary moment was: my god, what if I cure my prostate cancer and get Alzheimer’s? The good news, your cancer is gone. The bad news, you can’t remember you had it in the first place. My mood sank.
My mind went, unbidden, to a despairing thought. Is this all worth it? What if I do get a cure, but the treatment gives me dementia? Screw it. I’ll just give up. This is too much. Cancer and this risk? Too fucking much.
It was the sort of thing I’d usually suppress. Nope. Not gonna consider that. Enough already. Get back to the workout, let the exercise drive it away.
No. What? No, I said.
Oh, ok. What, then? Let’s look at it. Yes, dementia/Alzheimer’s scares me. But. The risk is an increase in the percentage likelihood of my becoming demented. No dementia or Alzheimer’s on either side of my family in my first level relationships. I exercise, which protects me to some degree. I challenge my intellect, learning new disciplines, painting, writing. Studying Latin, Judaism. If my risk is low, as I believe it is, then a 20% increase is probably negligible. Let’s say I have a risk level of 25%. A 20% increase in that would take me up to 30% overall. 2/3 of US Alzheimer sufferers are women, too.
Now the cancer risk. ADT increases my chances for a cure in the 5 to 10% range. Radiation puts me at 65 to 70% chance of a cure. With the two together my odds become 70% to 80%. And, I have the cancer. Right now. Conclusion for me? Follow the treatment. Take the risk.
Result? I don’t have a suppressed fear. I looked at it, recognizing anxiety that seems natural to me. That anxiety prompted me to look more deeply. I’m making an informed choice to stay with the treatment.
Speculating further after my post on Wild, Wildness, Wilderness. Wilderness is a place where humans rarely go, a place where the ebb and flow of life depends on plants and animals, not the artifice of roads and streets, buildings and houses, stores and parking lots. (I’m bracketing the climate change influence for the moment.)
Thought about cancer. Realized that the interior of a human body, even, perhaps especially, your own body, is a wilderness, too. Rarely visited by humans, very, very rarely by yourself-colonscopies, imaging work, sonagrams, echocardiograms being exceptions, of course, but in those cases the boundary of the wilderness is not opened. It’s penetrated by beams and rays and sounds.
As my old internist Charlie used to say, “We’re all a bit of a black box inside.” The inner world is not all that’s hidden from others; the inner world of the body is hidden, too.
We carry wildness and wilderness with us wherever we go.
The wind blew up last night as the sun set. With it came the yellow cloud, lodgepole pine pollen. The yellowness, which looked like smoke, refracted the deep reds of the evening sky. Coulda been fire. The fine yellow powder settles on everything. We’ve been lucky so far because the rain has knocked down a lot of the pollen. Not now.
It’s a wild sexual orgy, a sign of midsummer, as the lodgepoles go through their ancient reproductive strategy. Here’s an evocative sentence from Walking Mountains: “With their strobili unabashedly protruding and their ovules wide open, the young gametophytes stand ready to receive the blasts of pollen from trees near and far.” 50 shades of green.
When I was in Lone Tree yesterday, the truckometer read 100. I drove the older Rav4 since Kate volunteered to take Mary all the way to the airport. Stifling.
Sushi Rama
Two weeks out of seven over, 10 fractions beamed into my prostate fossa. The weekends are off. I’m finding I really like the break. To reward myself for a solid two weeks of radiation therapy I followed Ruth’s recommendation and found Sushi Rama. So-so. But fun. The conveyor belt idea works very well, I imagine, when the customer base is large and consistent throughout the day. Variability in a burb makes some sushi get that old and tired look.
Jimmy Johnson. Woolly, artist, designer, wayfinder, South Dakotan. He emphasizes an old men’s movement idea, the wild man. Find your inner wildness. Keep it alive. Present. That way our vitality remains.
OK. But. Cancer. Is wild. Exhibits a form of wildness that has no care for its environment. Only about replication at the expense of whatever can feed it. Sorta like capitalism. Especially fossil fuel companies.
A certain form of inner wildness has found me and I don’t like it. It’s the opposite of the wild man’s inner wildness. Instead of bringing vitality it feeds on life until it is no more. Again, like capitalism, especially fossil fuel companies.
In another sense though cancer’s wildness is no different from any wildness. It’s red in tooth and claw, survival of the fittest it’s prime directive. This vast forest, the Arapaho National Forest, in which we live is like that. Wherever there are deer and elk, there are mountain lions. A Rocky Mountain truism.
The mountain lion feeds from its environment, is ruthless and opportunistic. As an apex predator, the mountain lion may have no enemies here, but after the mountain lion dies, the forest will absorb their essence, put it back into the plant world. Which feeds the deer and the elk. The circle of life.
Cancer is part of this. It’s an element of the natural world just like decomposition, photosynthesis, a mountain lion attacking a mule deer. This wildness within me lives by the laws of natural selection. It doesn’t care who I am anymore than the mountain lion cares which mule deer they can catch. Cancer is predator and I’m its prey.
Luckily I have a means of fighting back. Even so, cancer is wily, persistent. It’s an open question whether this prey can take out so formidable an adversary. TBD
