On choosing to live

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Tiny White Box newMy mother read a lot of books, but one she clung to like a Fundamentalist to a red-letter Bible was a memoir called First, You Cry by Betty Rollin, an account of her battle with breast cancer and the emotional and physical effects of mastectomy. First was published in 1976, the year I barely graduated high school (3rd from the bottom of my class, much to my mother’s shame, not so much because of the actual result, which came as no surprise, but at my pride in having done so poorly). This was just a few years after my mom had her own radical mastectomy. All mastectomies are radical, of course, but here it means the removal of both her breasts and underlying muscles, along with lymph nodes extending all the way to her underarms. She lived another 30 years.

First You Cry Rollin Betty 9780061042355Three weeks ago, on my 65th birthday, my body was pierced, robots were inserted into my lungs to extract a tumor and some lymph nodes, the booty was sent off for analysis to high priests of science, I was pumped full of painkillers for two days, and I foiled a plot to kill me.

You read that right, and you deserve at least a brief explanation of that conspiracy.

Not much to tell, really. Using the keen insights gained by a combination of a hellish bouillabaisse of pain and a whole bunch of medications, on the second night after surgery I realized one of the nurses—who may well have had a twin or two!—wanted me dead. The first clue was the change in the unit. While I’d slept, what had been a standard-issue medical facility was transformed into a prohibition-era speakeasy, with the nursing staff now hiding out like bootleggers. While I lay there, unable to move, I was able to overhear talk of getting rid of me. A nurse, who had seemed very kind, brought me what he called “medication,” but what I knew to be poison. I sent him away, but his twin shortly appeared, wanting to talk with me about my concerns. I explained I didn’t want to die, and he said he understood. Within a minute, either the first nurse or a third twin, came back with a small plastic cup with the same poison. None of those nurses could fool me, though. Ricin, a deadly poison, is made from castor beans and the pills the nurse carried looked remarkably like beans. Even a 4 year old could connect those dots. As above, my physical torment and medicines gave me the most obvious response to this threat. 

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Speakeasy, aka a front for medical torture.

I tore the IVs out of my arms, covering myself in blood and leading to all kinds of activity at my bedside. This had the effect of transforming my room and the nursing staff back to their previous reality, getting me moved to a new, more intense, unit, and a whole bunch of cleaning. 

And, of course, foiling a plot to murder me. Three weeks of home recuperation haven’t revealed any more nefarious plans against me, so I suspect I’m safe. 

These 21 days, though, have been spent trudging the familiar landscape of depression. In the past, my depression hasn’t always, or even usually, been connected to external events. That is, Winston Churchill’s Black Dog of depression typically arrives unbidden if unwelcome. This time, though, with a cancer diagnosis and surgery at my back and facing treatment and possible death, I think depression is a reasonable response. Still, it sucks.

When the pathology report from the surgery came in, the news was overall good. Unfortunately, with cancer, “overall good” is nothing like “clean bill of health.” It’s more like, “Overall, the bride’s dress escaped most of the blood.” Red blood on white satin stands out, as does “the tumor was removed successfully, as were a number of lymph nodes, one of which contained cancer cells.” My cancer has spread, maybe not a lot, maybe not systemically, but even a teeny-tiny bit of cancer is like a perfume with a dash of n-butyl mercaptan, the spray skunks use to spoil a picnic. 

Veteran readers know I think about life a lot, and death more than most folks. When I received the medical news, my thoughts went back to something I wrote a couple months ago, about wanting life to be deeper if it must be shorter. When I wrote that, I pictured the choice between a brief, deep, Keithish life versus one extended by the torment and life-destroying force of chemotherapy. I was prepared to choose the former over the latter—until the evidence changed. Let me explain.

I thought I had some understanding of chemotherapy: the victim is lashed to an intravenous tube for a year, poisoned repeatedly and mercilessly, and left to sit in a padded chair in a hospital’s back room. In my mind, the procedure is declared successful if the patient crawls to life’s finish line, hairless, weighing 93 pounds and unable to lift the comb he will never need again. Life may have been extended for six months or a year, but only in the same way a fine beef stew can be extended by pouring gallons of water into it. Both become tasteless, lacking the very essence of life or stew.

Apparently, I was wrong, or so I’ve been convinced by the oncological-industrial complex. According to my doctor, chemotherapy has been greatly refined over the past 15 or 20 years. Rather than a year of toxicity, he is recommending a course of three months. Rather than being bound interminably to an IV, my treatment will take three or four hours a month. Rather than having the strength of tea brewed for the 40th time through the same bag, I’ll be able to drive myself home. I’ll feel like garbage for a week, then start to recuperate for two weeks, then be dunked in the poison again. Will I have nausea? Probably. Diarrhea? I guess. Weight loss? Almost certainly.

Still, it’s only three months of my life, it improves my chances of living another couple years (or, perhaps, even more) and I’ll be able to be myself—for better or worse—for most of the process. So, I’ll be around a bit longer, having chosen to live over letting nature take its course. I’ll try to return to being a regular correspondent, sharing my take on life, recovery, death and various other topics. I’ll use the time remaining (and may it be nearly infinite) to live life to its fullest.

Unless I’m wrong about my safety from murder plots.


About this Author

Keith Howard

Keith Howard is former Executive Director of Hope for NH Recovery and author of Tiny White Box