The Anova Cancer Care office has an entrance opening onto an asphalt parking lot. It’s in the corner of a large commercial building and looks like all the other non-medical companies in the structure. Glass, aluminum, tan colored stone facades.
The waiting room has a small refrigerator with soda and bottled water, snacks, and a round table with Prostate Cancer books arranged neatly on it. Carmela, the receptionist, who knows everyone’s name, asks about Irish Wolfhounds. I have on my Great Lakes Irish Wolfhounds sweat shirt.
They’re the largest dogs, right? The tallest, yes. But not the heaviest. We had a lot of them. Do they eat a lot? No, not as much as you’d think. Carmela has gray hair, but looks to be in her early fifties. She’s wearing an unusual layered frilly top. She apologizes. This is considered an office visit so I’ll have to collect a co-pay. Of course.
Then we wait. Kate’s reading a Parker book, a mystery of sorts. I’m reading Pico Iyer’s book about living in Japan, Autumn Light.
Charles. It’s good Amanda. Go to your left, please. I turn to my right even though I heard her. Oops. A bit distracted, I guess. After all, I’m going to hear the results of the bone scan which is one component of the imaging work. Do I have metastases in the bone?
Dr. Gilroy, who likes shirts with plaid patterns, comes in. I’d noticed a scan image on his computer when I entered the room, wondering if that was my insides.
Well, the bone scan was clean as a whistle. No mets. I want to jump up and down, but I say, thank you. Following with, the CT has been approved.
Dr. Gilroy. The auths. We can order, but the insurance company. Well. He shakes his head. Frustrated. The authorizations part of our tangled web of a health care system disappoints all parties. The only exception? The small groups of office workers who enforce them and the companies that profit from denials.
I’ve prepared a folder filled with documents about how to mount an axumin scan appeal, ready to go toe to toe with New West authorizations. I think we can make this happen if we need to. Dr. Gilroy shakes his head.
Let’s wait. If the CT scan is negative, then we’ll know it’s a localized recurrence. If the CT shows a lymph node really lit up, we’ll know that’s a target. Only if the CT is indeterminate will we consider the axumin scan. It’s easier for us, because it’s one scan and done. I put the file back in my lap.
Later on a call from Centura Health and my CT goes on the calendar for May 30th, next Thursday. Gilroy’s out of town, but will be checking in. If, he says, the scan is negative, we’ll schedule another office visit to discuss radiation for the prostate fossa, the spot where that corrupted organ used to lie. He surprises me when he says, That’ll mean 35 visits here. Not the Cyber Knife, 3-5 visits. 35 sessions is the usual radiation protocol. My friend Dick Rice had it. Our house cleaner, Sandy, had it.
In three days it will be 8 months since Kate’s bleed. They’ve been difficult. With Kate’s feeding tube placement scheduled for June 3rd and my second, probably last, imaging work next Thursday, we may be emerging from the trenches.
Kate’s already back to some level of normalcy. Walking more, loading and unloading the dishwasher, cleaning up after I cook. In the most hopeful scenario for me, Dr. Gilroy’s talking cure. Maybe sometime this summer we can take a pause from medical interventions. Would be nice.
Spent yesterday and Saturday reorganizing the loft, continuing work in the Intensive Journal. Oh, and made a meatloaf. Better than my mom’s. I printed a copy of Jennie’s Dead as it is so far, about 50,000 words, found my third draft of Superior Wolf, and pulled out the Phantom Queen which I haven’t seen in years. Today and tomorrow I’m going to file the remaining documents from CBE religious school, mussar, First Sundays. Then, I’m going to take each book that is piled up near my chairs, give the top ten priority for reading, and shelve the rest.
Tomorrow the whole rising PSA matter gets lit up and scanned by the hospital’s p.e.t. machinery. Takes about 30 minutes, slowly moving from pelvis to head. This moves me from an indicator based concern, PSA, to the reality of where the cancer is now, in my body. I’m hopeful there are no metastases, of course, that whatever has returned is confined to the prostate fossa. I’m not ready for my expiration date, but, then, I suppose nobody ever really is. The best result in this case is a localized reemergence treatable with the Cyberknife.
I come from a long line of mothers. So do you. This thought always strikes me as strange. Think of how many things had to go right for you to exist. Sure, there’s that whole randomness of the sperm that crosses the finish line, but think historically, think evolutionarily, think all the way back to that first organism that took the lightning bolt or the warmth of the undersea vent. Whenever and however life first appeared. Your existence, and mine, means we exist in an UNBROKEN chain of reproduction from that first wiggler, that first animate entity. One after another after another after another, for billions of years. Maybe 4.1 billion years according to 
Go now, the workshop has ended. Paraphrasing the end of the Catholic mass. Appropriate in this case having just come Mother Cabrini’s shrine. The experience of being at Mother Cabrini was familiar in its physical surroundings. In college I would always retreat to Catholic sanctuaries to be still, to reflect. I always found them/find them, soothing.
Here are two examples of next steps that have me excited. The first is to do a dialogue with reading. In the dialogue section of the journal, orange tabs, there is a method for developing one to one conversations with people important to you, living or dead, fictional or actual. That seems to makes sense. But the other four tabs in the orange section: Works, Events, Society, and the Body perhaps not so much. It works though. The journal method posits that a dialogue can be had with work you’re doing. I wrote a dialogue with Superior Wolf and in it realized I needed to pull the novel apart and focus one story only on Lycaon. In the Body section I’m in the midst of a dialogue with cancer.
It’s a bit strange to be at May 10 and have the temperature at 24, snow covering the driveway, the roofs, the walkways. In Minnesota the safe time for planting was typically May 15. Don’t think it would work here, at least not every year. We warm back up next week. For now, though. Winter wonderland. Like, I wonder why it’s still winter?
Read yesterday in the group. Iam asked me afterwards if I was a professional writer. Well, I write novels. But, I’ve not sold any so I don’t know if I’m a professional. Drina, who works for a website connected with the founders of 
We wrote spiritual steppingstones, what experiences in our life have led us to our current spirituality. Those of you who know me know that it’s been a long journey. An ongoing one, too. I would characterize my current spirituality as a tablespoon Taoist, two tablespoons existentialist, a teaspoon Christian, a teaspoon and a half Reconstructionist Jew, and a half cup of paganism (of the earth, the sun, the starting of the universe, aware of it and finding it enough). Mix together and bake until dead. Then, we’ll see.
