Friday, July 14, 2017

Moving on


Friends and family have asked what they can do. For Wendy, well, she's not sure herself. She will let you know. For me---I do have a request. I would love to hear from you, but I'd especially love to hear about fun things that you're doing. Vacations, hikes, trips to Bora Bora, funny grandkid stories, kid stories, amusing pet stories, interesting movies you've seen or books you've read, athletic events, parties, theorems you've proved, whatever. Jokes are always good. For instance, I am probably the number-one fan of Jay's legendary sense of humor (I may be the unique person who loved his ``Gangnam Style'' video). Here's one I got from Jay in response to my ``invitation to my funeral'' post. I loved it then, and it still makes me smile now. He said that he too had a dream:

Steve reaches the front of the line at the Pearly Gates. St. Peter looks up from his list and raises an eyebrow.
``Mitchell? Really?''
``Yeah, I'm kinda surprised myself.''

I used to think it would be bad form to go on about how much fun you're having to a dying person, but now that I'm in that position I realize that, at least for me, exactly the opposite is true. I want to hear all about it! The flip side is that I used to think it would be equally bad form to go on about things going wrong in your life. Not so. If you stubbed your toe and feel like venting about it (hey, stubbing a toe can be really painful), I'm happy to listen. I may be dying, but I'm still the same old me. The last thing I want is to spend what time remains being gloomy and doomy or being treated with kid gloves. Please just be yourself; there is no right or wrong thing to say.

I do want to revisit a couple of more serious (but not gloomy!) points that I've written about in earlier posts. The first is the ubiquitous obituary line ``so-and-so died after a long, courageous battle with cancer''. When I see that line, I always picture a person who has suffered through the countless indignities of chemo, radiation, immunotherapy and more, a person who tried literally everything before finally succumbing. A person who would have tried the atezo that I declined, a person who would not have declined the new chemo as I just did. It's impressive, and puts me a little on the defensive. Is stopping all treatment a failure of courage? I like to think it is not. There is a cultural-philosophical issue, namely that in our culture it seems that even dying at 65 (well, I'm going to try for 66!) is a kind of gross injustice to be fought to the bitter end, until finally we are dragged, kicking and screaming, to the other side.

There's a New Yorker cartoon in which a man and the Grim Reaper are sitting on the couch watching TV. The caption: ``All right, just one more episode.''

Sure, I'd like another episode. A whole season would be nice. But death is just a part of life, and for me, there comes a point where it is better to just accept it as gracefully as possible. Dying suddenly of a heart-attack would be simpler and cleaner, but in a way I'm grateful to have had these three years to think about it. That might be the one advantage of dying of cancer.

On the practical side, so to speak, we have a family vacation on the Oregon Coast coming up at the very end of July. Now, although the oncologist said my symptoms were all from the cancer, the timing and the fact that pembro can produce similar symptoms leads me to believe that the pembro at least added to the problem, particularly the fatigue. Since we've stopped the pembro, I'm hoping that I'll get a little window of time where I feel better than I do now. If I were to start that chemo, however, I'd have to start it right away (otherwise there is no point). That would totally ruin the vacation time with still more fatigue, nausea, etc. etc. That makes no sense to me, given the low probability of even modest results. I want to get the most out of every day.

The second point regards accepting death with peace and equanimity, not fear or resentment. This is of course a very personal matter, but I can tell you what works for me. The key is to strip away every layer of egocentrism (there are several), and to put myself into that Big Picture of which I am a microscopically tiny part. First of all, there is nothing special about my death. Everyone dies; that's just the way it is. Furthermore, at least in my case, there is nothing ``unfair'' about it. On the contrary, I've been extraordinarily lucky.

When I say ``everyone dies'', one's first thought is probably of the here and now, and of people---relatives, friends---that one knows, or at the next level, fellow travellers of the 20th and 21st centuries in which we've lived. I like to go further and pick a particular historical or prehistorical period and imagine those who lived and died then. Today for some reason I've been thinking about the first humans to cross the Bering strait into North America, and the innumerable generations that continued the journey to the south. They lived; they died. Just like us. Contemplating this gives me a deep sense of peace. It gives me a feeling of solidarity, if you will, with those people of long ago, and strengthens my belief that death---at my age, at least---should not be viewed as a tragedy.

At the next layer we have the notorious egocentrism of the human species. We like to think that we are special, that we somehow deserve a better fate than a starfish, a hummingbird, or a coyote. No. We are all part of the same amazing Animal Kingdom. And why stop at the animals? A wildflower, a saguaro cactus, a towering redwood---they live; they die. They die because they were born. Then there is the host of plants and animals that are now extinct. The variety of extinct pre-vertebrate marine animals alone is mind-boggling. And all this is just on Planet Earth! We have no idea what else lies out there.

When I put my own life and death in this context, within the infinite beautiful cycle of life and death of all living creatures, in its turn embedded in the vast mysterious fabric of Space-Time, I can feel only awe, wonder, gratitude and a profound peace.

The end is my beginning.














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