The Best Death

We had a talk about death last night. It was a good talk. In fact, a great talk. Death is an open conversation for us. It’s always there weaving in and out of every conversation and through our running chats about food and books and friends and politics and yes, sex.

But there was something else last night. Cancer, I’m sure, opened the conversation, but somehow we went deeper than before. We talked about the how of death, and would we help each other die, and how would we know we were ready. What part would be pain, and what part would be exhaustion, and what part would be a sense of readiness?

And all day today as I went back to that conversation I realized something new—something that has changed for me and that, maybe, is also a bit of acceptance.

For so many years—especially in my younger years—I always imagined that a sudden death and an unexpected quick death would be the very best kind. When we play that hypothetical, “How would you like to die?” game I’d always thought that a plane crash or explosion or something sudden and relatively painless would be the way to go. I’ve heard many others say, “die in my sleep” or “die in my lover’s bed” or “die in my recliner watching my team win”…all to suggest that a fast, unexpected death would be the best kind.

But today I realized that I want more from death than that. Maybe this comes from being a control freak, or maybe its because I love process, or maybe it’s because I really do want to place each of my scarves in a friend’s hands—but I want time to know when I will die. I want to know it will be six months or six weeks. I would choreograph each of those scenarios very differently. I want to say good-bye and give my things to specific people. I want to make love dying. I want to say words and hand out books.

And given all of that I realized something about cancer that I never considered before: It may be the very best way to die. Cancer, for the most part, gives warning. Many cancers have some kind of timetable. Cancer lets you have at least a little time to say, “Wow, here we go. This is really going to happen. What do I want now?”

For all the war against this thing and all the battles waged, and all the agendas that insist we should have no cancer consider this: If you accept that you will die, and you know you will die of something, cancer could be the best way to die.

Poetry Month: Raymond Carver

Do you remember the moment when you heard, "It is cancer"? Raymond Carver shared this moment from his life and his cancer in his poem,

What the Doctor Said:

He said it doesn’t look good;

he said it looks bad in fact real bad

he said I counted thirty-two of them on one lung before

I quit counting them.

I said I’m glad I wouldn’t want to know

about any more being there than that

he said are you a religious man do you kneel down

in forest groves and let yourself ask for help

when you come to a waterfall

mist blowing against your face and arms

do you stop and ask for understanding at those moments

I said not yet but I intend to start today

he said I’m real sorry; he said

I wish I had some other kind of news to give you

I said Amen and he said something else

I didn’t catch and not knowing what else to do

and not wanting him to have to repeat it

and me to have to fully digest it

I just looked at him

for a minute and he looked back it was then

I jumped up and shook hands with this man who’d just given me

something no one else on earth had ever given me.

I may have even thanked him habit being so strong.

--Raymond Carver

Young Adult Cancer in Fiction

Two new novels with stories themed around cancer are new releases. What's remarkable is that they are both very good novels apart from the cancer storyline and from the fact that both are published in the Young Adult category.

Likely the publishers booked them as "YA" books because the main characters are teenagers but be assured these are powerful, well-written and emotionally mature books. Yes, they are great reads for folks you know 13 to 18 who have a friend with cancer or who want a serious, non-vampire read. But they are also for those of us who love a good novel, with complex characters, engaging narrator, and great writing.

They are:

"The Fault in Our Stars" by John Green   and

"The Probability of Miracles" by Wendy Wunder.

Add these to your library list or get them at your local independent bookstore--in our Albany Capital Region that is The BookHouse at Stuyvesant Plaza in Albany or Market Block Books in Troy.

50/50

Maybe like me you put off watching the 2011 comedy/drama 50/50. I didn’t watch it for a year. I assumed it was either a sappy, tearjerker about cancer, or a gross, expletive-deleted, Seth Rogan 20-somehting boy story. I didn’t know, and didn’t realize, it was both.

Watched it last night and we laughed and cried. Yeah, John too. I am glad I didn’t see this at the movies with friends though. Not because the cancer scenes cut so close to home but because there is one boy-to-boy discussion of girl friends and sex acts that made me blush. If I saw this movie on a first date I’d leave the theater in sunglasses and go right home.

But, we’re not dating, we’re married, and we've done that sex act many times, and I’m laughing as I type this, Ok it’s funny.

And yes, Seth Rogan is mostly a pig but, a pig with a heart for friendship and some insight into how guy pals talk and fight and love each other. Yeah, the movie is a love story and –spoiler alert—the love object is not Anna Kendrick.

I would put 50/50 in my top three cancer movies. Check it out. But not on a first date.

Cancer in the Movies

Not so much cancer on TV but we do have some cancer in the movies.  They are few and far between but we can find some. Here’s a list of my picks for top cancer flicks:

          Love Story

1.                       The Barbarian Invasions

3.                       Terms of Endearment

4.                       50/50

5.                       Wit

6.                       Sweet November

7.                      My Life Without Me

8.                      Erin Brockovitch

9.                     The Bucket List

10           Stepmom

What movies am I missing?

Cancer on TV

If we know that one in 5 people has cancer and that cancer touches every family, and that most Americans watch more than 20 hours of TV a week--how come we don't see much cancer on TV?

Doesn't it seem that there should be cancer references and cancer experiences represented on regular TV? Yes, we have the fabulous ShowTime "The Big C" with Laura Linney but what about cancer in Modern Family and South Park and How I Met Your Mother and The Family Guy?

At any moment each of us knows someone with cancer--family member, extended family member, co-worker, in a friend's family etc. Someone has a diagnosis or is going thru treatment. Someone is dying or surviving. So where is that in our TV lives? Shouldn't there at least be a minor character with cancer? a mention of taking a casserole (yes, lasagna) to someone's home? Someone bald or in a chemo-scarf?

Cancer is in our lives, so how about our TV lives?

Cancer is so 19th Century

Read today's New York Times article by science writer Gina Kolata about why the word "cancer" may be on its way out:

http://www.nytimes.com/2011/11/22/health/cancer-by-any-other-name-would-not-be-as-terrifying.html

The Pig in the Python

We, the “Baby Boomers”, were born between 1946 and 1964. Nice numerical bookends to remember who we are. I was born in 1953 so I’m nicely embedded in the center of this large, unruly, and predictable but independent demographic group. We are—according to demographers-- the “Pig in the Python”—so named because they can watch us move along the lifespan and longevity track.

Yes, we know there are so many of us and we know the benefits. Wish for a more comfortable shoe for your middle-aged feet? Ten new brands. Want a vacation geared to an aging but not willing to admit it body? Thousands to choose from.

But here’s a fun fact to pause and think about: Our big group is aging together and we are getting—and going to get—disabled together, and we are going to have more and more and more cancer together. This is the consequence of our “Boomer Bump” combined with better healthcare. The longer you live the more cancer, and more likelihood of cancer, you’ll have.

So we all have a very selfish and very altruistic reason to care about cancer. If you too were born between 1946 and 1964 cancer is coming soon to a body near you.

Cancer has a Sweet Tooth

I’m reading the new book, “Sugar Nation” by Jeff O’Connell and it’s an eye opener. I’m generally pretty healthy and mindful of eating well except for this little issue of sugar! I love candy—the chewy stuff: licorice, gummy bears, fruit slices. I have rationalized that candy like that is low fat and relatively low calories so I chew away. Except that it’s been nagging at me.

Jeff’s book is about the consequences: insulin resistance, Diabetes Type2 etc. Now those conditions are scary enough: Heart disease, blindness, neuropathy and amputation. Yeah, that last word gets your attention right?

But then this: cancer has a sweet tooth.

Jeff writes, “Recent research shows that the consumption of high amounts of sugar and refined grains boost the odds for cancers of the esophagus, kidneys and pancreas.” And this, “Excessive insulin, produced internally in response to high glucose can raise your risk of being diagnosed with a number of cancers including colon, breast and liver.”

And the surprise: “The link between obesity and cancer may not reflect obesity itself so much as insulin levels being high.”

Later in the book Jeff describes the incidence of “metabolically obese thin people.” People who are fit of body and often healthy looking but internally have the same metabolic responses as someone quite obese.

Another statistic is the cincher: “Government statistics say that Diabetes Type 2 is the seventh leading cause of death in the United States. But that ranking is an illusion. Type 2 diabetes covers its tracks by ending a life some other way—a stroke, heart attack, toxic shock.”

Or cancer.

A Free Workshop for Women Concerned with Cancer--- & Caregivers

To Life! Presents... Beat the Odds
A Workshop with Breakfast and Presentations for Women Concerned with Cancer—Patients and Caregivers.

This Wednesday in Saratoga Springs, New York:

Wednesday, August 10, 2011  at the Gideon Putnam Resort

24 Gideon Putnam Rd, Saratoga Springs

Breakfast at 8:00 am Presentations to follow at 8:45 am

The Role of Genetics in Cancer Diagnosis & Treatment

Presented by Luba Djurdjinovic, Executive Director of the Ferre Institute

Hormone Therapy—What is Right for You?

Presented by Dr. Vinita Singh, Medical Oncologist at Samaritan Hospital Cancer Treatment Center

Caregivers: Perspectives on Caring for Your Loved One

Presented by Diane Cameron Pascone, Times Union columnist and teacher of caregiving courses

To register call To Life! at (518) 439-5975 x22, or e-mail lglavin@tolife.org.

The Big C

We are watching the first season of the TV series “The Big C” starring Laura Linney. (Last seen as a family caregiver in “The Savages” with Philip Seymour Hoffman”). The Big C is wonderful, witty and thought provoking. And it hits every stereotype about cancer: the smarmy platitudes, the saccharine support group, the “cancer is a gift” message and the “your anger caused your cancer” craziness. Linney just explores and pushes back in the most wholly human and imperfect ways.

The premise of the show is great: What would you do if you were diagnosed with a late stage cancer and you knew and your doctor knew but there was some delay—weeks? months?--before anyone else knew. In that cocoon of time and spiritual space who would you become? What  would that secret knowledge let you try out before the expectations of “cancer patient” surround you?

Cancer Doesn't Correlate

We so badly want cancer to be caused by something other people do that we don’t. She used to smoke. He eats so poorly. She’s a worrier/has a lot of anger/doesn’t express feelings. He was always in the sun. Maybe it’s a family thing? Was there cancer in his family? Didn’t her sister have cancer?

It’s our voodoo hope. “If I don’t do the things the things they do I won’t get cancer.”

But no, cancer doesn’t correlate.

Love in the Time of Cancer

Here is a true story of Love in the Time of Cancer. This is from today's New York Times from Tara Parker-Pope who writes the "Well" column in the Times' Health section. This inspires humility. Not just two cancers but a baby too. Click below and read on:


http://well.blogs.nytimes.com/2011/04/11/a-couples-knot-tied-tighter-by-dual-diagnoses/

War on Cancer

We often say that someone endured a courageous battle with cancer, but the truth is—it’s the doctors who are doing battle and the patients are the prisoners of war.

How Not to Die of Cancer

I’m re-reading Siddhartha Mukherjee’s wonderful book, “The Emperor of All Maladies—a biography of cancer.”

He says so many things that are obvious after you read them but that we don’t think about day to day. Such as: “Cancer is imprinted in our society: as we extend our life span as a species, we inevitably unleash malignant growth (mutations in cancer genes accumulate with aging) so that cancer is thus intrinsically related to age. If we seek immortality, then so, too, in a rather perverse sense, does the cancer cell.”

This is one of the reasons people in the developing world have more cancer. We live long enough to get cancer.

So how to not die of cancer:

Die young.

Die of malnutrition.

Or die of TB, cholera, malaria, dysentery, or any of the prevalent fevers in the second and third worlds: Choose from River Fever, Dengai Fever or Scarlett Fever.

Cancer Cancer Everywhere

A beautiful late winter snow day…tons of unexpected snow and I am in my flannel pajamas at 5pm. Delicious. Also delicious: today I made real Mexican hot chocolate concocted with a bar of real dark chocolate, cream and hot red peppers. And my new toy: a battery operated wisk. (Almost as much fun as other battery operated devices.)

But a soft drum beat in the distance: cancer, cancer, cancer. An old friend has breast cancer, a new friend has bone marrow cancer, a coworker’s child has brain cancer. In today’s paper a reminder that while we oooh and ahh over breast cancer and even colon cancer it will be lung cancer that will kill the most. Lung cancer kills seven times more than all other cancers put together.

Why no ribbons or races or fashion shows for Lung Cancer?

Because we think it is deserved by smokers and their families. A subtle shaming and discrimination. But get this: 80% of all lung cancer diagnoses are in folks who never smoked or who quit decades ago.

What color should the ribbons be?

Little Rebel Cancer Cell

A story today in New York Times about dentist’s use of radiation. Dentistry radiation is not regulated and the levels in the new machines are higher etc. It got me thinking again about that little cancer cell. It’s that one lone cell that goes off in the wrong direction—that changes—that starts the cancer. That one “trouble-making” cell.


But what if that cell, that little guy is—however misguided—trying to save our lives? I mean, look at what we do—the chemicals we eat all day long, the medications we take all of our lives, the radiation we pour into human bodies to check for cavities and broken bones and acne. All good stuff by themselves. And all the things in our environment that have changed in 50 years. Maybe none of it is dangerous by itself—I am not a “don’t drink out of plastic bottles” girl. But what might be the collective effect?

And that one cell—Brave? Misguided? Hopeful? Says, “No” and heads for the door. “I am gonna change”, she says. And yes the door turns out to be a wall or a cliff—but the little cell says, “Enough, I’m changing.”

Can you blame her, really?

The little cell tries something new—tries growing—tries changing—and it starts a reaction that becomes cancer.

Haven’t we all done this? Had enough of the pain, the problems, the same old same old and said—“That’s it I’m trying something, anything”. We tried to go blonde when we had olive skin, or tried to lose weight using diet pills. Or we tried plastic surgery or Botox. Enough said. We have all done bad relationships, bad jobs, joined groups that turned out to be cults or just enormous wastes of time. We say, “It’s just part of growth” when we do it or our favorite nephew does it.

But the little cell that tries to change—we declare a war on her.

Like Keith Richards Inside Us

Today is the official publication date for “The Emperor of Maladies” by Mukherjee. It is being widely and wonderfully reviewed. In Sundays New York Times Book Review this quote:

“Cell growth is the secret of living, the source of our ability to build, adapt, repair ourselves; and cancer cells are rebels among our own cells that outrace the rest. If we seek immortality, Mukherjee writes, then so too, in a rather perverse sense, does the cancer cell.”

Is that cancer cell rebel –in its little black leather jacket and bad eyeliner --simply misunderstood?

You Can't Kill Cancer

The reviews continue and the controversy picks up for Dr. Mukhergee’s biography of cancer-- “The Emperor of All Maladies”.

Here is another quote from the book:

“Cancer is a flaw in our growth, but this flaw is deeply entrenched in ourselves. We can rid ourselves of cancer, then, only as much as we can rid ourselves of the processes in our physiology that depend on growth—aging, regeneration, healing and reproduction.”

Cancer Men

This is just too good! I found this when searching for info on love and cancer:

Cancer men are incredibly appealing to many women. Cancers seem to have insight into what makes a woman fall in love. They are creative, passionate and loyal. When you meet a cancer for the first time you may be instantly smitten. They have been known to sweep a woman off her feet after only a few short dates.