Serious Business

“Don’t worry, be happy"

--Bobby Ferrin

The process is intensifying. After the first sequence of chemo, we went to Palm Desert for our annual family holiday vacation. I had a few very manageable side effects, as well as a respite from the chemo process. We returned in time for my next infusion on Dec. 27^th. Experienced chemo survivors have told me that the intensity is cumulative, so I’m not surprised that I am feeling more limited after this week. Kathy said it’s a fatigue like nothing she’d ever experienced, and I’m just beginning to understand what she means. So far, it’s strictly physical, though. What I’m experiencing is in the body – the spirit remains entirely willing and open to all the new revelations. One after another, what were only concepts in my mind are manifesting as veritable realities that I experience in my body, spirit and soul. I am recognizing just how powerful is my need to control, all the while thinking that I was learning to let go. Well, I was, ever so slowly, but more able to talk about it than to enact it. Now, even though, much of the time, I still have a choice, I am discovering that it is much easier to let go, and let others take over. Most surprising to me is the new-found freedom and joy in the surrender. Whatever the fear was that underlies my need to be in charge, it is gone, replaced by the sweetest experience of relationships that I have ever had.

Our Palm Desert holiday was everything I have ever wanted from a family gathering. Not laboring under some requirement that I be at the center of the action released me to be a playful participant in the activities as they evolved without interference. Only once did I try to make something happen. It did not go well, convincing me not to try that again! Van and I had four delicious days with gorgeous weather, just the two of us. Peter and Denise, Holden and Courtney (son, grandson and their S.O.’s) joined us for a week, which overlapped for four days with Elizabeth, Joe and Jesse (daughter and her children), and son John. I had packed a few decorations and suggested that if anyone wanted a tree, I’d be up for it. The outcome was the loveliest of trees, provided by Peter and Denise, with help from Courtney and me. We did have rain - an opportunity for games and movies and working the 1000 piece jigsaw puzzle provided by Holden and Courtney. Every day, rain or shine, started for me with the hot tub jets soothing a painful spot on my back, followed by a therapeutic, body-stretching swim in the warm, warm pool. Three pleasant days later, Elizabeth, Joe, Jesse, Van and I headed home.

For the first time, an inner voice is beginning to question, “will this be the last time I will go to Palm Desert…trim a Christmas Tree…buy face powder…or moisturizer?” So far, any discomfort that I experience has not masked the aliveness, curiousity, appreciation that I so keenly feel. As never before, I understand what Mary Oliver means when she writes:

When Death Comes

When death comes

like the hungry bear in autumn

when death comes and takes all the bright coins from his purse

to buy me, and snaps his purse shut;

when death comes

like the measle-pox;

when death comes

like an iceberg between the shoulder blades,

I want to step through the door full of curiosity, wondering;

what is it going to be like, that cottage of darkness?

And therefore I look upon everything

as a brotherhood and a sisterhood,

and I look upon time as no more than an idea,

and I consider eternity as another possibility,

and I think of each life as a flower, as common

as a field daisy, and as singular,

and each name a comfortable music in the mouth

tending as all music does, toward silence,

and each body a lion of courage, and something

precious to the earth.

When it's over, I want to say: all my life

I was a bride married to amazement.

I was a bridegroom, taking the world into my arms.

When it's over, I don't want to wonder

if I have made of my life something particular, and real.

I don't want to find myself sighing and frightened

or full of argument.

I don't want to end up simply having visited this world.

A New Chapter

“Life is either a daring adventure or nothing at all” - Helen Keller

So far, my life continues to feel like an adventure, even with the mounting challenges. Tomorrow I begin a round of chemotherapy. I had hoped to avoid this treatment but am now finding myself curious about what it will mean, how I will experience it and what changes, inner and outer, it may necessitate. Already, as I learn more about my nutritional needs, I have made changes in my eating habits and am better informed about nutrition generally. For some time, I haven't felt much like eating, although when offered food that someone else has prepared, I'm hungry. For the moment it seems that eating is not the problem, cooking is. When Carol said she was preparing a turkey breast, could she bring one over to us, without hesitation I gratefully accepted the offer. That is new behavior – my midwestern upbringing, a control issue or just a habit has always required much protest whenever someone offered their help.

When one part of a system changes, the whole system is altered as a result. That is what has happened to the system that is me. As I continue to accept, without resistance, the abundant and generous offerings of food and assistance, my experience of myself is changing. While the creaks and twinges in my body may be associated with the process of aging and exercising less, I am noticing the adjustment my body is having to make as ancient tensions are releasing. I know from my study of psychology that our defenses must resolve slowly lest the exposed vulnerability be too tender to endure the experience of pain. It would not surprise me if, similarly, there is discomfort in the body as the long standing patterns of holding slowly let go. The pain is in balance, though, with an ease in relating to the outer and an absence of worry. The welcoming of these gifts of food, time, loving attention and support with thanks instead of protest, validate my belief in the mutuality of the process of giving – that people really mean it when they thank me in return for receiving their offerings with an open heart. I am not surprised since I know that my service to others benefits me perhaps more than it does those I serve.

I have never felt more connected to my fellow humans. I am now sitting in the chemotherapy suite, a long room with several reclining chairs stretched along the windowed wall. My chair is tucked in a corner, facing the windows, where I can see the tops of autumn-colored trees against the blue sky. Across from me is a very fit-looking young man, working on his laptop with his earphones in place, hooked to the machine which is infusing him with whatever drugs his disease requires. I will probably refrain from asking him what brings him here, although I am curious. There are many young people here, some my age, and some in between. I, too, have my laptop, earphones, and books, and, maybe most appealing, the opportunity for a nap! I'll be here a few hours, at least two, maybe four. I will come back in a week for a second infusion, then there will be a week off. This sequence will repeat four times, interrupted once for my annual trip to Palm Springs, with the blessings of my doctor.

I have been writing this post over a week's time now, having arrived at the Saturday before my second Monday infusion. I am propped in my bed, writing on my laptop in bed, another “first.” So far, my spirits are not impacted by the chemo, but I do feel less energetic physically. Laurel just brought lunch, gave Van instructions for preparing it, and came up to visit me, in my bed. At this point, working from my bed is a luxury, rather than a confinement; learning how to be active and rest at the same time – so many new experiences.

My cancer will not be cured, but the healing continues and deepens.

Another Round

Quoting from Mark Vonnegut (son of Kurt) in his new memoir,

"My father gave me the gifts of being able to pay attention to my inner narration no matter how tedious the damn thing could be at times and also the knowledge that creating something, be it music or a painting or a poem or a short story, was a way out of wherever you were and a way to find out what the hell happens next and not just have it be the same old thing."

When I read this, I knew why blogging has become so important to me. Caught up in the busyness and demands of my life, I have not been giving myself any creative time lately, and it's beginning to take its toll. I am becoming increasingly aware of Francoise (the harpsichord) sitting in silent rebuke and of the lament of my inner voices growing more insistent. It's been over a month since my last report, and, while my inner psychic responses are holding steady, the cancer is not. I'm well into another round of radiation, targeting a tumor in the subcutaneous layer of my right side just below the rib; and also a tumor on the pelvis which is beginning to invade the cortex of the bone. Except for being able to see the lump on my right side, I experience nothing from these presences. If I hadn't seen them on the scan, I might think it was all a hoax.

As with my previous radiation treatments, I have no side effects, except for an adjustment to a new routine. My body's natural alarm is 7AM but, to be ready every day for a 7:30 radiation treatment, a biological clock change was necessary. It has become a part of the adventure, to be awake and out in the darkness with the other early risers, something warm in the to-go cup and music playing that I have been wanting to hear. I've learned to go to bed earlier, and I'm hoping that after the treatments are over, I can maintain this schedule as a way to regain the lost creative time – an unexpected gift from the radiation.

Nevertheless, I have not felt a lack of creative spirit since life itself seems so creative to me now. At the end of September, I turned 79, beginning my 80th year. In fact, by Chinese reckoning I am 80, since in China you are one year old on the day of your birth. Van woke me up on my birthday with a youtube concert of “our songs,” songs from the days of our courtship and early marriage, evoking the sweetness and depth of 60 years of memories. Steve and Laurel created a CD of the concert for us, inspiring us to try dancing again!

I am surprised and delighted these days by the joy I am experiencing with my friends and family. The big events - the births, marriages, deaths - and the simple shared moments –a hug, a conversation, a concert, a meal. To the hundred years of blessings that our home holds in the being of its structure, was added this month the joyful family shower for beloved cousins, Natalie and Eric, expecting their first baby in early November; and the exquisitely touching wedding for Angie, Tenzin, and baby Loden, particularly meaningful because I had been deputized to perform the lovely ceremony created by them.

Also this month, The Stanford community, our neighborhood, and friends and family came together to remember Nelee Langmuir, our friend and neighbor who died in August. Nelee held a salon, attended by the coming and going of many, many friends, during the days she was dying. Conversation, food, and wine flowed, as Nelee flowed in and out of alertness. Her services were held this month in Stanford Memorial Church, another structure of more than a hundred years, holding a rich store of blessed memories for me and thousands of others. How fortunate I am to have this model as a guide for my future!

No less meaningful for me are Robert's hug on a Sunday morning; Laurel's sharing of her time, talent, and hospitality; Frank's friendship and shared appreciation of Philharmonia; Jim's treating me to personal organ concerts; Faith's constant and comforting presence in my life - only a glimpse into the riches nourishing me from the people in my life. I am very grateful.

What Now?

Thank you all for your generous support and feedback! I am feeling so well-nourished by your heartfelt responses, as well as safe and secure. I know when the time comes to cross over, I will have to go alone, but I find my fear of that moment diminishing. I am reminded of the 17 year old Barbara leaving for college, the 19 year old leaving for Europe, and the 21 year old leaving for a whole new life of marriage, all with a mixture of fear and excitement, all with loved ones left in their grief, happiness and a little relief, waving good-by. What I know now, that I was not consciously aware of then, is that the separation was eased for me by all the caring and love that I had unwittingly absorbed from that community of friends and family. The adjustment afterwards for me was fraught with the difficulties and resistances of growing up, and I don't know what I have waiting for me in this instance. What I have learned from all the sturm und drang of my life is that I do better when I can stay focused on what is right here to do now.

Thanks especially to those of you who have been questioning me. Some of you are asking ,”Where is the fight,” as in Lawrence LeShan's well-received book of many years ago, You Can Fight For Your Life. “Are you just accepting it?” Others are wondering if I've given any thought to the emotional, psychological, personal relationship to my cancer. Hasn't much of my life been devoted to the search for understanding those connections? Yes, but has it been too much in the service or desire to control the lives of others without enough regard to my own life and process? Sweet Courtney gently says, “You know, you worry a lot about others...” And I am asking myself, “Is this another opportunity to confront lifelong issues of avoidance and boundaries?”

My internal response to “are you fighting” is a mixture of contemplating the philosophy of aikido, which I find attractive but actually know very little about; realizing that I may have accepted the diagnosis, but not really the prognosis; determining with the force of a fight to stay conscious and actively live in every minute. The question of psychosomatics is knottier for me. I have spent a lifetime exploring this terrain, beginning with my childhood in Christian Science. My family left the church when I was still quite young, but not before I had learned how to disempower illness and bodily discomfort. Much of my early professional work centered on incorporating practices of the mind-body connection into western medical settings. Yet, should I be asking myself, “How did I invite this cancer to grow inside me? Am I doing everything I can to keep it from flourishing?”

I'm not sure there are certain answers to these questions. I certainly don't know. What I do know is that we are all powerless over the forces of nature, not helpless, but powerless. How I treasure the hours spent in the garden with Jeff gently demonstrating this truth over and over again ( I am NOT a quick study in this regard). “We'll plant it at the right time in good dirt, where we know it might be likely to grow; we'll give it the right amount of water and food; then we'll see what happens.” Sometimes, although we tended them well, the plants did not flourish; sometimes they died.

So far, my pondering leads me to invoke the prayer that says it all:

God, grant me the serenity

To accept the things I cannot change;

Courage to change the things I can;

And wisdom to know the difference.

Results

I can't remember a day in my life that was harder than today, unless it was yesterday. Everything in me resists causing others pain or discomfort. One of my life's lessons is learning to bear the suffering of others, but to be the agent of pain feels unendurable. Yet, here I am enduring it. Yesterday's news was not what we had hoped it would be. Like a weed popping up in other spots in the garden, the cancer is spreading. The good news is that I will have time, perhaps a year, perhaps more, hopefully not less, in which, with consciousness, to soak up all the blessings of my beloved relationships, the comforts of the music I love, the numinosity of nature. I plan to continue my life as it is, continuing to watch it unfold as it will, but making choices in consideration of an ending that may come sooner than I had planned.

Much more research must be done before treatment of lung cancer can be as effective as that of some other cancers, but I am grateful for the huge gains in pain management. As symptoms develop, chemotherapy is an option to reduce pain by shrinking tumors, but it's efficacy in prolonging life is limited. Except for the pain of having to be the bearer of these tidings, I am feeling so good that there is a screen of denial protecting me from what I know in my mind is an excruciating reality. I can see through the screen, but what I see is hazy, muted. My benevolent inner guide is holding me in the moment, a difficult moment though it is... I think I will go take a walk before continuing.

Back now, with the residue of my thoughts while walking still on my mind. I was thinking about how well-timed our road trip was, including, as it did, so many people dear to me, so much natural beauty, and the satisfaction of feeling a part of it all. I left you (a blog or two ago) driving across the Canadian prairies, listening to country music. After a long day's drive, delayed at the border by the rather sour border patrol (no fooling around since 9/11), crossing the more populated, seemingly less expansive North Dakota prairie lands, we came into northern Minnesota, to Grand Rapids, and finally to our destination, Twin Lakes. The community there of family and friends epitomize the warmth, inclusiveness, and hospitality I associate with life in Minnesota. It crossed my mind that this might be the last time I would visit the cabin, hear the soulful, lonely cry of the loon, swim in the fresh, clear water of the lake (don't have the strength to swim across anymore), rest in the gracious acceptance of that family – my family. In China, when a girl marries, she leaves her people to become a part of her husband's family. Often she feels isolated, unaccepted, bereft. Young, insecure, spoiled, and prideful, without having to give up my own, I married into Van's family, one of the gifts of my charmed life. Reading the cabin log book, I realized how many times over the years we had been to Twin Lakes and recovered memories spanning the whole 57 years of our marriage. Memories of the tough times were there, too, but mellowed and sweetened by the passage of time.

Next, we drove south with daughter Elizabeth (Betsey), and grandchildren Joe (15) and Jesse (12) to Faribault. Their home sits in the beautiful rolling farmland characteristic of southern Minnesota. A gift of Betsey's husband, Bill, was his love of the land. He devoted some of their land to the restoration of the prairie, put in 1200 plants to create habitat, and cut a path through the woodland for me to walk. Betsey has a huge garden, from which she provides food, preserved, frozen, canned for the winter. She is a true Minnesotan! The weather in the north had been spectacularly beautiful, typical of the best in my memory. The weather in the south was too hot to do anything outside – Van didn't even go out to play golf. The day we left, the heat lifted, reminding me of how lovely it can be, especially in the fresh, clean air of the country.

The last chapter is our drive home, a route we have taken many times - through South Dakota , sharing the road with lots of Harley motorcycles returning from the famous rally in Sturgis; into Montana, where we visited Steve, Hilary, and baby Chase, who hadn't been able to join us at the lake; down to Yellowstone, with suggestions from Hilary, a bearologist, who lived there while studying the resident grizzlys. She said we'd be likely to see more animals on the east side instead of taking the more familiar road on the west. Very soon, we spotted a magnificent elk, further on a pronghorned elk, herds of bison grazing in the grasses and sporting in the river, and finally, a bear! The drive out of Yellowstone was a little tedious, but rewarded by the Grand Tetons, rising suddenly out of the plains.

Forgoing the expense of staying in Jackson, we went on to Twin Falls, Idaho, and the next day, into Nevada. On one of our former drives through Nevada, we had discovered a pottery studio and workshop in the tiny (only 14 year-round residents), remote town of Tuscarora. We were surprised to find that the artist was a Stanford graduate, whose family had relocated to Tuscarora and established the workshop in this little artist's colony. We decided to see if the shop was still there, which indeed it was,and, to our delight, so was the artist, Ben Parks. After buying another souvenir to match the one we had purchased before, Van was willing to continue on the remote, unimproved road, leading eventually back to the highway. The last time we had taken this road, we did not have an appropriate vehicle, which made Van very nervous. It is not in my stubborn, determined nature to question the wisdom of such a venture, which is why being married to Van is another example of my good fortune - as is, that time,making it safely back to the highway! This time, however, we had our all-wheel drive new car, the only risk being that we would be covered with dust. Along the way is the reward for the effort – a beautiful reservoir, solitary in the midst of the astonishing silence of this high desert. Only walking in the snow through Betsey's property, or maybe above the treeline in the Sierra, have I experienced such quiet. We ate our picnic lunch without talking, taking it all in. Back to the highway, on to Reno, down, down to the flats of Sacramento, stopping to see son Peter in Vallejo, across the Bay Bridge, down #280, and home.

Many years ago, in her 80's, musing about her life, Van's mother said, “Oh, but I have my memories...” As I approach 80, I'm beginning to understand what she meant. Memories are the riches of the old, sustenance for the soul. Our trip awakened old memories and created new ones. I am feeling very wealthy and well-nourished, ready for the continuing adventure.

Interim Report

When I returned from work Tuesday evening, there was a message that Dr Gillis had called and would call back the next morning at 8AM. My heart skipped a beat. I hadn't expected to hear about Monday's scan so soon. At first, I was thinking that maybe she wanted to let me know quickly that the radiation had shrunk the tumors, and all was well, but Van said, no, in fact she had indicated that there were some areas of concern. Disturbing dreams; wide awake at 5AM; dressed and ready for the call which came at 8:10. The good news that, indeed the original tumors were greatly reduced was overshadowed by the “areas of concern:” several new spots of cancer, one on the pelvis, one on the rib, and two more above the heart, all small, but nevertheless, indicating that the cancer is spreading. Hard to hear; glad Van was listening in - I've had to keep asking, now what exactly did she say? She did go on to say that there are treatments, and that Dr. Canales will be prepared to outline the possibilities at my appointment with her on September 10^th.

Helen, with whom I was supposed to meet that morning, was waiting for my call to say what time I'd be ready. “I might as well go on with my day as usual...I'll be there abut 9:15.” So that's what I'm doing – going on with my life as usual – so strange, everything's changed and nothing's changed. The last two days I've spent getting used to being a person with a chronic illness. I'm sure there will be treatments, lasting one, two, maybe more, years. I'll let you know what I find out about that next week – that's why this is “an interim report.” I'll also continue with the other three chapters of our wonderful trip, since several of you have been asking. My thoughts are full right now of all the things I want to do, a kind of bucket list, I guess. Not a bad thing, having time to indulge in the gifts of life, with full knowledge that it is going to end. Already, the sights as I ride my bike to work are more vivid, the people I meet are dearer, the experience of it all, sweeter. I don't know if this heightened awareness can last – I'll keep you posted...

A Journey Within A Journey

It's hard to believe that the next benchmark on the journey is only two days away. On Monday, I will have the PET/CT Scan which will show how the cancer is responding to the radiation treatment. I am not without some anxiety, particularly since I returned from our wonderful trip with a couple of troubling symptoms, which may or may not be related to the disease. I saw one of my docs today, who said that we will just have to wait for next week's scan. Here I am, reaching out again for your supportive thoughts and prayers. I'll let you know the results just as soon as I have them. Meanwhile, the waiting is providing more opportunity for reflection on all the possibilities. Dr. Canales was quite clear that we can't expect a cure, but that there is a good chance of containment. My night thoughts are mostly about preparing for the ultimate inevitability, while my day thoughts focus on what I have to do today.

Our auto trip (the journey within) was enormously fulfilling for me and full of wonders, beginning with the drive up the splendid Oregon coast on a stunningly gorgeous day. We stayed in Tacoma, within walking distance of the Chihuyi and Tacoma Art Museum and in view of Mt Rainier, stately, ethereal Mt. Rainier, appearing and disappearing in and out of the Washington clouds. It reminded me of our trip to Huang Shan – we arrived there in a heavy overcast, and I expressed my disappointment to our guide that I wasn't going to be able to see any of the beauty. He brushed aside my concerns with “Don't worry, don't worry.” As he said it, the mists were clearing away to reveal a Chinese painting of mountains and valleys, which continued to disappear and reappear. The on-going life of the natural world is so comforting to me...the little hummingbird that faced me in the window over my kitchen sink, hovering with it's tiny beating wings, saying, “It's O.K., we're all here,” and just staying there until my pain could melt into the vast and blend with all of life.

The next step of our magical journey was Jeff's 50th Birthday Party. One approaches Jeff's house through a nondescript neighborhood, entering an overgrown, dirt road alley. Finding a stairway, constructed of grates nestled into a hillside (not good for high heels, but Jeff says no one that ever comes to his house wears high heels), one feels thrust into the story of “The Secret Garden.” A breathtaking profusion of flowers and plants, familiar and unfamiliar, in pots, in beds, surrounding sweet little lawns, room after room of them, cascading down the hillside, the rest of the world out of sight, out of mind; the burgeoning vegetable garden, the cozy chicken coop, the house, restored and decorated as only two strong, able, creative men would do it. The whole evening was out of another childhood storybook - when Bert took Mary Poppins and her charges into the picture he had drawn on the sidewalk (his day job) to have tea in an English garden. Amazingly delicious food, lovingly prepared and served by Jeff's friends, the table beautifully and simply set outdoors in one of the garden rooms, attended by his parents, who have finally, after all these years, embraced their son as he is, and also his four wonderfully individual older sisters who never stopped doting on him – all of it was magical.

Two days later was the storybook wedding of Jimmy and Annette, Barbara Toothman's son and now daughter-in-law. Annette's father is on the music faculty of The University of Puget Sound in Tacoma, and all of her family are performing musicians. The wedding took place in a sea of music, graceful tradition, hopefulness of bright, fresh youth, and palpable love. Along with nature, this is the kind of experience that helps me in the discouragement about the future that I often feel these days. I'm thinking, though, that it's just a part of growing older, the “what is this world coming to” feeling that threatens my mood and serenity. Hasn't every generation come to that in its later years?

Now we go from magic to magnificence, the Canadian Rockies - Jasper, Banff, and Lake Louise. This is our first visit to this part of Canada. We've been through the Rockies in the U.S. several times, and, of course, the Sierras, then a couple of years ago drove through the southern Utah canyon lands. Those trips were like lead ins to the main show, the mighty, rugged, exquisite Canadian Rockies. We spent three days, exploring Jasper and Banff; lunching in the historic Lodge at Lake Louise; catching sight of a grizzly, preventing us from taking a planned hike because, when present, she and her cubs reign supreme; on to Moraine Lake, into which Van fell, attempting to get just the right picture (the only wound sustained being his pride); and ending with Van surrendering to my earnest desire to go on to Emerald Lake and Takka Falls, in the Yoho Preserve, often missed because it exists in the shadow of the much more widely known Banff National Park.

We could have spent the entire vacation time there, still only scratching the surface of the richness of the area. The gorgeous scenery is marred only by the devastating pine beetle infestation. Normally, the pine beetle is naturally controlled by cold winters, birds, and fires which destroy the older trees. Now, with the winters significantly warmer and fire suppression allowing trees to mature ( the beetles prefer the older trees), it has proved impossible to contain the destruction. They are doing what they can in an attempt to control it, as well as harvesting as much of the destroyed forest as possible, (which has to be done as soon as possible after the trees' demise). It's heartbreaking for me, like nature's equivalent of war or genocide. I comfort myself by remembering the recovery of the forests after the Yellowstone and Point Reyes fires.

Very suddenly, driving along the next day, we found ourselves in a totally opposite natural setting. From the intense verticality of the mountains, we were in the equally intense horizontality of the Canadian plains. The sky became huge, the land stretching out endlessly, the restfulness of the prairies allowing for processing the magnificence of the mountains, of life. It was time to listen to music. Van and I have different musical tastes, and our road trips give us a chance to share our differences with each other. Driving across the plains calls for country music, which we both can get into and which the radio abundantly provides. There is often some wisdom embedded in the hokiness: “Hindsight is knowing where you've been; Foresight is knowing where you're going; Insight is knowing when you've been here too long.”

At this moment, my insight tells me that this blog entry is getting too long. I'm only reaching the end of Chapter Two of our journey – there are three more to go. I'll leave you for the moment with my request for your good thoughts on Monday, and, as always, with my gratitude for your attention.

To be continued.