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.

Very bad news, alas

Note: I will write a longer post in the next few days. For now, just the essentials.

The bone scan showed nothing, but the results of the liver scan are very bad. The main tumor has tripled in size, for example, and the satellite lesions have coalesced into larger ones. The oncologist says my symptoms (fatigue, abdominal pain) are definitely due to the cancer and not the pembro.

So the pembro isn't working and will be discontinued. The doc is reluctant to put a number on things, understandably, but says it is very possible that I will die within two months. I will try to beat that number, of course, but it's pretty clear that this is the beginning of the end. We looked at the scans, and the dark areas corresponding to tumor are beginning to overwhelm the light (healthy) parts. Hospice care is now part of the conversation.

The doc mentioned one (and only one) further treatment that could be tried. It is another type of chemo. He wasn't at all enthusiastic about it, and for the first time in the process put doing nothing on the table as an option. My decision at this point is that I'm done with treatment. I'll explain this in more detail in my long post, but the short version is the usual story. The new chemo isn't likely to work, and will make me feel a lot worse.

Don't worry about me. I'm fine, really, and totally at peace with the situation. The one in need of support is my wonderful wife, who is very strong but I'm sure could use that support.

And don't forget: It's a beautiful world!

Get out of jail free

My big scan day was much shorter than expected. They were able to eliminate some of the down time, and I was only there from 11 to 3.

Beth the Nuclear Medicine technician takes me back to put in an IV and injects me with weapons-grade plutonium. Then she hands me a small orange piece of paper with something scribbled on it. ``This is your get-out-of-jail-free card,'' she says. If you set off a radiation detector in the next three days and homeland security asks you ``Are you carrying radioactive material?'', you can say, why yes sir I am, in my body, and show them this." I guess I'll be glowing in the dark for a while.

I also had to fill out a form that asked, among other things, whether I'd ever had a bad fall. Well now, back in 1972 I had a rather long one. This led to a pleasant conversation about Yosemite, concussions, and the fact she was formerly on a Search and Rescue Team. When she was a kid in 1969, Beth's parents took her to Yosemite and to Haight-Ashbury. Those were the days. Well, we'll see you back here at 2, says Beth.

Then on to the CT-scan, same-old same-old, except that the IV is already in. Drink the KoolAid. Enter the spinning vortex of the Intergalactic Wormhole Transporter. Hear the voice: Breathe in. Hold your breath. Breathe.

Back for the bone scan at 2. I wasn't worried about the ``lying motionless for one to two hours'', because if I've learned anything in my hospital experience it's that you have to go straight to the source for reliable information. You can't believe the patient information brochure, or a receptionist, or even a radiologist. In this instance, you need to talk to a technician who actually administers the scans. So I called Nuclear Medicine a couple of weeks ago, and talked to in sequence a receptionist, a radiologist and a technician. All were very nice and very helpful, but it's the technician who has the real scoop. Oh, don't worry, she said. There are plenty of opportunities to go the bathroom, and the longest continuous scan is no more than 25 minutes.

Not only that, but Mark, the technician who did my scan, announced at the start that ``we want your bladder as EMPTY as possible''. Can do, sir, can do!

The bone scanner is an impressive, gargantuan device. It has two huge semi-circular arcs behind that rotate two rectangular gamma-ray devices through 360 degrees so as to scan from any desired angle. ``Airport rules,'' says Mark, ``all metal objects in the tray.'' My arms are held to my side with a wide strap and feet held together with a big rubber band. ``The first scan is 20 minutes.Just lie still and breathe normally. Most people take a nap.'' It turns out that the arrangement is very comfortable. I did briefly doze off, and would have been fine with forty minutes. There is a short break and then a five minute head-scan, to see if any brain material is still there I guess. The photos are then sent to the radiologists to see if they're satisfactory. That was about fifteen minutes, still lying comfortably on the ``bed'' (minus straps and bands). In fact I asked Mark if I could stay another hour or so to nap, but that was not deemed an appropriate use of resources.

I'll get the results of both scans tomorrow. Meanwhile, my pembro symptoms have gotten worse. The fatigue has gotten much worse, to the point that I find it intolerable. Numerous naps and lie-downs per day. If I'm lucky I can get two hours of work done.

Going on walks is non-negotiable, but it's gotten a lot harder, with shortness of breath on hills that I was cruising up effortlessly before the treatment. If it keeps up like this, I will seriously consider stopping the treatment regardless of the scan results. I doubt the bone scan will show anything; that clavicle pain went away completely a few days after I talked to the onc. But I am having increasing right-side abdominal pain, which I don't think I can be explained by muscle strain and the like.

Well, enough complaining. To help make it more endurable, I came up with a brilliant idea. According to the Mad Dog Code of Honor, watching television in the morning is strictly prohibited. Well, okay, I make the occasional exception when the Seahawks are playing on the east coast. But it really it is a very poor use of time, especially for a morning person like me. One consequence of the Code is that I have never been able to watch Wimbledon live, except for one time when I happened to be in England.

Then it occured to me: if ever there was a time I could justify it, this is it. If I get up at 6:30, I'm typically having my first nap by 9 and not getting much done anyway. So a little Wimbledon, why not? I have officially given myself permission, and if anyone has a problem with that, we'll have to take it outside.

In conclusion, here's a Kaia story I recently heard from Jessie. Why Kaia was thinking about this in July, I don't know, but she came to Jessie asking whether Santa Claus was real. ``What do you think?'' Jessie replied. ``I think it's you and Daddy.'' At which point Jessie confessed the truth, and was relieved that Kaia was not upset by this. In fact Kaia had decided it's the same with the Easter Bunny and the Tooth Fairy: ``There's a pattern there.'' However, Jessie requested that Kaia not say anything yet to Finley. Kaia was okay with this, but said:

``I'm worried about Finley. What if when he's a Daddy he still doesn't know? He won't know to put the presents under the tree.''

Infusion no. 2 and other diversions

I had a triple appointment yesterday (three and a half hours, with breaks): blood draw, then the oncologist, then infusion. The oncologist meeting is to go over the results of the blood draw and to discuss any side-effects I may be having. The levels of a certain enzyme associated with the liver are again high, even higher than they were before. As to side-effects, the concerns I expressed in previous posts were certainly overblown (I must sheepishly admit, baa baa). The most prominent of these is fatigue---more on this below---but there doesn't seem to be anything you can do about it. I've had some stomach upset too, but not too bad. Then you start wondering: gosh, I'm out of breath walking up this hill; is it the pembro or am I just out of shape? However, when I mentioned to the onc that I'd done a nine-mile Father's Day hike with Jessie, he kind of laughed and said he wouldn't worry about out-of-breathness.

The other new development is that I've been having various pains on the right side of the abdomen. My theory is that these are due to too much tossing the grandkids around and/or some of my blackberry hacking, both of which could stress rarely-used muscles. But since the right side is where the liver is, it seemed a good precaution to mention it to the onc. In particular, I've been having some weird pain in and around the right clavicle. The onc suggested two possible cancer-related explanations: First, the tumor in the liver could be pressing on the bottom of the diaphragm, which can cause pain---so-called ``referred pain''---in a completely different area such as the clavicle. Second is the worst-case scenario of cancer spreading to the bones. For that reason he wants me to have a bone scan.

Personally I think this is all a very expensive wild-goose chase; I'm guessing it's just some kind of muscle or ligament tear resulting from carrying around garbage cans filled with heavy weeds. On the other hand, I've had so many blood draws, CT-scans and infusions that I'm getting bored with them, and it will be interesting to undergo a new test administered by Nuclear Medicine (that's really the name of the department!). They inject you with something, I think radioactive waste from the Hanford Reservation, then you sit around for three hours to let it fully circulate (into your bones, I guess). After that they scan in some way. It will be interesting to see. Oh, I just got some new information: For the scan part you're supposed to drink lots of liquids and then lie flat on your back without moving for one to two hours. Yeah, right. I could also walk upside down on the ceiling while juggling seven hedgehogs and playing Rachmaninoff piano sonatas on the kazoo.

By the way, I was wrong about the first infusion being a half-dose. I was sure that's what they told me, but I was certainly pleased to learn that the second dose is the same as the first. Tom and Dana were there this time. Alway fun to see them.

Back to the fatigue: Sometimes I feel like I need to lie down every two hours. But I did the 9-mile hike, and of course remain true to my motto: If you don't feel like going out for a walk, you should immediately go out for a walk. Today for instance I did a double-hiller in the park. Although I felt fine during it, by the time I got back to the house I felt ready to collapse. I've discovered though, my motto notwithstanding, that it's best not to fight it too much. It seems ridiculous to lie down for a nap when I just had one two hours before, but it makes the fatigue manageable. Surprisingly, I'm even getting some good work done. Although I've been a total has-been in research the last few years, I'm actually writing a paper with my student (``The Duflot filtration in equivariant topology'', if you were dying to know). We'll probably submit it to a top journal such as Quilter's Corner or The Bass-Fishing Almanac. In any case, it's nice to feel I'm doing something again, modest though it may be.

The most exciting recent event was Mikayla Weissman's wedding. I could write a whole blog about that, but I'm running out of steam and will just say: Beautiful wedding. Beautiful bride. Amazing family. Amazing friends. Wonderful!

Pembro report: so far, so good!

My first pembro infusion was a non-event, as I more or less expected. I hope it continues to be uneventful!

Both of my previous Nurse Practicioners have moved on to other jobs, including alas Sarah the opera fan. The new one, Lisa, is not an opera fan (which surprised me because I thought this was a prerequisite for working in the urology clinic). Lisa has experience with pembro, although mostly with melanoma and lung cancer. She was very positive about pembro being a low-impact treatment. According to her, the most common side-effects in order of frequency are (1) fatigue, (2) dry, itchy skin, and (3) diarrhea. Many patients, she says, continue whatever they were doing before with no problems. Excellent! I can return to my plan of one-upping Alex Honnold, who's gotten a lot of press for his recent free-solo of the ``Freerider'' route on El Capitan. Oh come on, he rehearsed the route with a rope multiple times before going ropeless, and took four hours to do it. And it's only 5.12D, what's the big deal? My plan is to do it on-sight, at night, in under forty minutes.

The immunotherapy infusions are shorter and simpler than the chemo. First I go to the urology clinic where Deanna ``accesses'' my chestport and takes out a couple of gallons of blood for testing. Or maybe it was three teaspoons, something like that. At the first withdrawal she remarked ``oh, this is old blood''. Excuse me? Whose blood are you calling old! It's an hour 30 min. appointment, and although it doesn't take quite that long, it has to be done as a sterile procedure and that drags it out a bit.

Up in 8th floor southeast, I was disappointed not to see any of the old gang besides Rose. Tom, Dana, Glen, et. al. were all off travelling or otherwise enjoying themselves, the nerve! My infusion nurse was a new one (new to me, I mean) named Alyson. She's about my age, I think, and just got back from a bicycle vacation in Italy, in the region around Torino that we visited last September. She even speaks a little Italian, so that was fun. Like me, her first foreign language was French. After college she worked as a nanny in Paris for a while, and told me this story: In the US she often donated blood. Afterwards they give you a few crackers and a cup of orange juice. She thought ``why not donate blood in France as well''? So she did, and afterwards got a complete lunch with choice of red or white wine, followed by a sugar cube dipped in cognac.

The infusion part of the appointment was under two hours. They start you with a half-dose, then in three weeks decide if you can tolerate a full dose. So far, so good...

Had a great time at the Mariners' game last Sunday. Of course, it's always fun to be with the Brown family, but also we had great seats and it was a good game (2-run homer by Cruz, spectacular catch in left field by Powell...). It amazes me what a long attention span Kaia and Finley have for these games. For some time now they've both known how to read the scoreboard, and Finley keeps up a running commentary: ``It's looking good, guys! Runners on the corners, only one out, two balls and no strikes!''

In any case, there really isn't that much to report. No news is good news!

Follow-up to last post; decision made

There are several things I want to say in this follow-up to my previous post. First of all, I'm concerned I may have unduly upset some people with my funeral fantasy. That is the opposite of my intent. It's true that a big part of the purpose of this blog is purely selfish: It makes me feel much better to get these things out in the open. On the other hand, I really do believe that death after a full life is not some kind of tragedy. It is just a part of life and not to be feared. By making light of the situation, I am trying to convince family and friends to share this belief and not worry about me.

Second, the fatalistic tone of some of my blog posts should not be intrepreted as meaning that I'm giving up. Not at all. Indeed my problem is the opposite: Throughout the experience (chemo aside) I have consistently felt so good that without a dose of reality I could easily just ignore the diagnosis and proceed merrily along as though nothing was wrong. I need those dire statistics as a motivator to action. I publicize them in my blog because (a) as already mentioned, it is part of my way of dealing with it, and (b) it's important for other people to know. I don't want to write only a happy-go-lucky blog and then suddenly announce to my daughters ``oh, by the way, I have about three months to live''. I am doing my best to fight the cancer, but with a realistic attitude and without regarding death as some kind of injustice.

In fact another fantasy is that I am the first person to be totally cured by immunotherapy (see below for the decision). This would be very embarrassing, given all my dramatic posts about death. But I suppose I could live with the embarrassment.

Meanwhile, I'm happy, I'm enjoying life and just taking it day by day. You might be surprised to know what Wendy and I did on Wednesday evening, the day we got the scan report. We watched the last three episodes of season 13 of ER! Only two seasons to go...The next day I went to the Honors Luncheon, where a sophomore, junior, and senior from my differential geometry class were all getting awards as top students in their respective years. Another student from my mathematical reasoning class a year ago also got an award, so it was fun. A second top junior who I'd never met was sitting next to me. He's 17 and already taking graduate courses (I'm telling you, it's something in the air around here). Next year he'll be taking another grad course, called ``Manifolds'', which as it happens I will be teaching. At least a couple of these top undergrads will be in the course, which makes me all the more excited about teaching it. It's a year-long course, so obviously I must postpone croaking until at least next June.

After that I took my CRV to the dealer for new tires and a new battery. Hiking season is upon us, and it's no fun to be stuck at a trailhead with a dead battery (it's happened to me just once in my hiking life). However, I really am a total dork: for years I've just been hanging out at the nearby Starbucks doing math while they work on my car, although on sunny days I've wished there was a nice park nearby. Only now, and this is truly the epitome of dork-dom, did it occur to me to just look on my cell-phone map! There is a very nice little park just a block or two away. Never noticed it before. As any Seattle reader knows, Thursday was an absolutely beautiful day. After tiring of math, and with the caffeine wearing off, I just laid down on the grass looking up at the sky and the trees.

In spring quarter I restarted my Italian lessons with Elisabetta. As is our standard procedure now, I come in and tell her about and/or read aloud from my current novel (which Elisabetta recommended to me), ``The Charterhouse of Parma'' by Stendhal (pen-name of 19th century French author Marie-Henri Beyle). It's a good story and a lot of fun because it takes place in northern Italy with many familiar locations; of course for us it us ``La Certosa di Parma''. I use these lessons to deceive the cancer in the same way that the young woman of ``A thousand and one Arabian nights'' deceives the Sultan. After all, I can't stop before the end of the novel! I need to find another really long one, not War and Peace but maybe The Brothers Karamazov. Even the cancer will hold off to see how it ends.

Now, on to my third point: I've decided to go with the pembro. I do in fact have access to the New England Journal of Medicine (I knew this, but as I said, I'm a dork) and have now seen the entire article on the pembro study. Some readers have suggested that I've been overstating the probability of serious side-effects, and perhaps this is true. I do worry about it, but in the NEJM study the percentage of grade 3 or higher ``adverse events'' is 15 percent, which maybe is not so bad. The main reason for my decision, however, is simply that doing nothing does not seem like an acceptable option. I don't want to reach a point where it's too late to do anything---and this really could happen within a few months, conceivably---without having at least tried SOMETHING. The pembro appears to be the best available option. In the study it had about a 20 percent probability of ``objective response'', and in some cases the response lasts up to 12 months. Having liver metastases, however, lowers your odds (here's one of those grim statistics): according to the study, 145 out of 186 subjects with liver metastases are now dead. The bottom line is that to me, pembro is not the great advance that its proponents make it out to be (bear in mind the study is funded largely by the Merck corporation, which markets the drug). Nevertheless, it is recommended by my oncologist and really seems the only option. On the plus side, infusions are only once every three weeks.

Just making the decision is a big relief. Thanks for listening, and have a fabulous day!

Scan report: not good news...

I begin with my standard advisory: If you're squeamish about urinary symptoms, or about me talking about my own death, read no further.

It's been an interesting week. For the last five days I've had more or less continuous blood, and blood clots, coming out in the old urine. I assumed this meant the tumor was growing again in the bladder, but according to the onc, bleeding from a bladder tumor is ``like sunspots''; you can't really predict when it will happen and for how long. According to Monday's CT-scan, the tumor in the bladder has not really grown after all. In any case, there is no pain from it and indeed it doesn't affect me at all, other than being rather gross---for that last reason I thought I'd share it with y'all. Some of those clots, man, how did they make it through?

That's the good news. The bad news is that the cancer in the liver has increased significantly. The biggest lesion has gone from 4.2 by 3.7 cm to 6.6 by 6.2, and the other big one from 1.6 by 1.1 to 2.4 by 2.2. There are also ``multiple new satellite nodes'' surrounding the big lesion. For those who are rusty on the metric system, 6.6cm is on the order of two and a half inches. I saw the actual pictures too; relative to the size of the liver, it can no longer be called a small lesion. In addition, for the first time my blood analysis is showing some effects of the cancer on liver function. I still don't feel anything though; in fact if anything I've felt exceptionally good lately.

So I am at a critical point. If it keeps growing at that rate, the end could be much closer than I would like to believe. Certainly the oncologist's body language gave me a very negative impression. This brings me back to the immunotherapy decision. I suspect (and in at least one case know) that to many of my dear readers it probably seems an easy decision, under the circumstances. Wouldn't I immediately start the immunotherapy, as the best and possibly last hope?

But it's not that easy for me; far from it. In fact I fear, dread, and loathe the prospect of immunotherapy, for reasons I've discussed before. If the side-effects were temporary, I would have no hesitation in giving it a try. It's the thought of permanent side-effects, some of which really can be awful, that gives me pause. Needless to say, in this context ``permanent'' means up until the point the cancer gets me, an outcome which appears increasingly likely. That's just the point: as I see it, the choice is between (a) dying sooner but enjoying the time that remains more, and (b) living longer but with diarrhea, nausea, headaches, shortness of breath, skin rash, and in the end, in the worst case, dying from the treatment itself. There is always, of course, the third possibility of a miraculous cure, but absolutely no scientific reason to believe in it.

Today's discussion with the onc did nothing to alleviate these fears. On the contrary, he had some disconcerting news: A recent, randomized study of atezo showed that, statistically, it had no benefits at all! Great. Now he thinks I should try pembrolizumab, another checkpoint inhibitor that supposedly fared better in a recent trial. But what's to say that pembro won't go the same way as the atezo? And it has the same suite of gruesome side-effects, as far as I can tell. I've been looking around online, and haven't yet been able to access the actual article in the New England Journal of Medicine (maybe my wonderful sister Victoria can get it). But I've read the abstracts and various other blurbs. One proponent waxes enthusiastic about pembro because (in the study) patients getting pembro lived on average three months longer than patients getting second-line chemo. Well, excuse me if I don't get too excited about that. First of all the relevant statistic would be average survival time for pembro versus no therapy at all, and in any case three months is not a figure I'm going to jump up and down about---assuming I'm even able to do so with pembro attacking my lungs.

By the way, the trade name of pembro is ``Keytruda'', manufactured by the Merck corporation. Even on the Merck site, the list of possible side-effects is discouraging to say the least. It's true that some of them are rare. Others are common. And all this for only a twenty percent chance (according to the study) of getting even a temporary benefit. I honestly don't know what I'm going to do.

There is a daydream I have about my own death. It may seem silly, or pretentious, or both, but at this point I don't really care. It's a comforting daydream for me, oddly enough. It has elements of Lou Gehrig's famous speech, of the scene in ``Tom Sawyer'' where Tom and Huck attend their own funeral, and of a low-budget off-Broadway version of the Last Supper.

It's a large dinner gathering. Friends and family are there. The occasion for the dinner is unclear, but it falls on me to make a speech:

``I want to take this opportunity to invite you all to my upcoming funeral, date TBA. I won't be there, of course, but there are a few things I'd really like you to do: Wear bright, colorful clothes. Play upbeat, happy music. Laugh, a lot. Have an Immortal IPA, in remembrance of me.

``You see, my death is not an occasion to mourn. I've been incredibly lucky in life from day one, from the family I was born into, to my wonderful wife and children and grandchildren, to my friends, my work, my health. Yes, even my health. Think about it: I've never so much as sprained an ankle, let alone broken a bone. I fell 150 feet in Yosemite, and came out of it with just a concussion and a broken nose. I had a mild form of epilepsy as a child, but even that went away; for 65 years I've never had a serious illness. Even with cancer I'm lucky: a world-class medical center is just a short, beautiful walk from my office.

``Hell, during the Vietnam war, my draft lottery number was something like 343, meaning there was virtually zero chance I would be drafted. I've led a charmed life really. If I believed in God, and had a chance to chat with him/her/it, I think I'd start by saying, ``Dude, thanks so much for a great life! It's been a wonderful run.'' After that I might get into the question of why I should be so lucky and others not. Things could go downhill and I could end up in the Bad Place. But I don't believe in God, so I won't worry about that.

``By the way, with regard to my ashes: please dispose of them in an environmentally responsible manner. I would be honored if you went to visit one of my favorite mountain haunts, but I sure as heck don't want you carting a box of ashes around and freaking out the marmots. Just take your thoughts, and mine, with you. And be happy.

``So good night, I love you all, and remember this: If I catch anyone at my funeral wearing somber clothes or playing gloomy music, I'm going to be really pissed off.''

Back to reality: The sun is back, at last, in Seattle. Kaia's butterflies have emerged from their cocoons, and have been set free. It's a beautiful world.