miércoles, 17 de abril de 2013
In the late 1990s, I reflected at length on the struggle with cancer that I'd had earlier. Looking back on my entire life, this is what I came up with.
On a day like any other – it could have been any day – a minor complaint prompts a question. An inquiry. An examination. . . and suddenly nothing is the same. The things which were big things become small, and all that had been small things disappear. You feel the curtain falling, you see clearly the weakness of living, in an instant you recognise the fragile skin of life. Closing, the eyes truly open – and the turning world continues.
* * *
There is a moment in life when everything comes to a crashing close, when the silence is so loud that it drowns out the everyday sounds, when each of a man’s fears takes on a very real and terrifying face. For some, it is the moment of looking into the gun barrel, or the command to charge the bunker, or perhaps saying “I do.” For me, that moment was sitting in a small
examination room of completely unmemorable color, listening to a doctor in a white coat tell me that I had a tumor the size of West Virginia inside my chest.
The sweat starts, imperceptibly, and then comes the realisation that it’s in there, and nothing you can do yourself will get it out of you. But the man has been talking while you’ve been reeling with that data, and now he’s on to numbers: survival rates, percentages, things which can only be measured in retrospect, long after the deal is done, when you’re either laughing in Aruba or rotting in Pleasant Acres.
The person on the table, the patient, faces the man in the white coat – a man the patient has, incidentally, only just met, and who now has the thoroughly egregious duty of informing this stranger that his life has changed, or worse, is over – and stutters out a request for the doctor to repeat himself. It all has the tone of a very bad dream.
The wife, of course, cries quietly, seeing more clearly into the future than her patient husband. In the coming months, with any luck, this man will come to know the nature of this word patient, as a variety of doctors prod and lead and jerk him around in a display of human frailty that will seem remarkably life-like. But at this moment, he is too stunned to notice her silent tears, and she is too consumed with a single idea: this man must somehow survive.
* * *
I was a fairly normal guy, if I had to characterize myself. I could talk a little about wines and tobaccos, I ran a successful business and went to movies and had most of my beliefs in neat categories. I enjoyed jazz and classical music, I read voraciously, and I was very like most American men except that I had a predilection for introspection and very little interest in sports.
I also had a list in my mind of what it takes to be a man. A man doesn’t cry. He is always prepared – for anything. He doesn’t complain and bears his pain quietly. A man protects himself and those around him. He won’t exploit, depend or rely unnecessarily on his friends, nor will he take them for granted. In fact, a real man has a bit of the mom in him – he tries to have enough of everything to go around. As my Uncle Ironhand used to say, “Always carry your own bullets, or you risk carrying one of your enemy’s.”
Inside, I had the bricks and stones of a thousand walls to keep me safe, stones I had picked up on college campuses in the Sixties, bricks I had carried from the streets where crowds were teargassed and gunned down by police. I had faced cops with the bravado that only the very tough or very naïve can muster. I knew myself to be a little of both.
I had fought a war a long time ago: a war that divided a nation, a war that made one generation dig in its heels on social issues, inculcated another generation with a lasting distrust of elected leaders and sent a third – the youngest – into the apathy that passes for hipness. But I had taken at least one side and had held it for the entirety of my adult life. I owned the strength of conviction. It was mine and I would not lose it.
In my younger years, I had fought with fists and with sticks and with knives. I had faced opponents and won – or lost. I had placed myself at the very edge of rightness and wrongness – out where matters are settled like men and, as in the sports pages, the outcome is never in doubt because the man standing won the contest and the man on the ground lost. I knew I was strong and, win or lose, I could fight if I had to.
And, sitting in that room whose color I cannot name, it became clear that what I had to do now was fight – fight the cancer, fight to stay alive, so all this philosophy became suddenly quite relevant. It wasn’t just a collection of testosterone sentiments, not the macho notions of manhood derided by the women in our lives over “lunch with the girls” or discussed fervently by “the boys” in the locker-room after racquetball. Like the adrenaline surge that dictates to mammals when and how to keep breathing, philosophy transmuted into the very real stuff of life itself. Of course, I was to also learn some distinctly different lessons in the months to come.
* * *
One of the many delightful ironies of my life is that, at forty-five, I was stricken by a young-people’s disease. The predominant window for Hodgkin’s lymphoma is 18 to 24 years of age. I felt, of course, quite lucky to find that I did not have non-Hodgkin’s lymphoma, a nasty and messy killer which takes thousands of lives per year with impunity. Hodgkin’s, on the other hand, is neat, clean and imminently curable – the doctors repeatedly puzzled me by calling it the “good” cancer.
The tumor was pressing on both my heart and my lungs, causing me to have poor circulation and extreme shortness of breath. Again, the ironies: as an educated man, I could not help but recognise that the tumor struck at the center of our collective notion of courage (courage comes from the Latin for “heart”). Moreover, the tumor attacked my lungs, where I breathe (spirit comes from the Latin for “breath”). How often in life do we hear these words matched up with our notion of manhood: “That fighter’s got a lot of heart;” “He has the spirit to win this one.” With these two areas so compromised, how was I to defend myself against this threat to my life?
And the effects of cancer weren’t merely philosophical. I was physically weak, I couldn’t work for more than a few minutes at a time, and could not sleep. I had lost twenty pounds to land at a feeble 160 and was tired all the time. The tumor was consuming almost everything I ate, leaving the rest of my body to starve. My life had turned around, and I wasn’t liking the direction it took.
In another doctor’s office, the silent language of marriage carried a single look between my wife and me: I would undergo chemotherapy and radiation treatments. A believer in naturopathic medicine for most of my adult life, I now abandoned all interest in healing “the healthy way.” Like many before me, I put aside distrust of Western medicine in my desperation. I would find doctors considered to be the best in their fields and learn to trust Western methods. My private realisation in that moment was that I would bite the bullet, even if it meant biting the damn thing in half.
So it all started out relatively badly and devolved from there. My wife drove me to the infusion center for chemotherapy every two weeks, because the treatment wiped me out too much to walk, much less to drive. Working from graphs which told the maximum I could take without dying, brisk professionals put poisons into my veins as I watched – and waited – for the effects. At the infusion center, they gave me palliative drugs for nausea and other side effects, but I hated taking them. I quickly reduced my intake of these additives to a minimum, resigned to pull in my ears and bear the physical discomfort.
My wife took me to weekly meetings of a “survivors’ group,” while she attended a “caretakers’ group.” We both learned new things about the realities of chronic and catastrophic disease in America at the dawn of the new century – and about the politics of disease. I learned that I was not alone – but I wasn’t exactly part of a group either: no one could do this for me. Though I had always done so willingly, now I must carry my own bullets, even while my strength dwindled.
* * *
Your first stab at patient logic tells you to try to deal with catastrophic sickness the way you have always dealt with the routine cold or flu – either one of two ways. You’ll try laying up and sleeping until you are bloody tired of being in bed and have to go back to work, well or not. Or, you’ll refuse to acknowledge that you’re sick and continue to work, fighting through it until you fall over from weakness and exhaustion.
As you would eventually learn, neither tactic works in the case of real debilitating disease. It is a hard thing to wake each day into the sickness again, without relief, to see yourself in the mirror more debilitated and feeble each time – the constant reminder of failing health, to know that you are not what you were, that in fact you are so much less than you were, that you are constricting, shrinking each day in your movement, in your strength, in your already-severely-limited abilities. And added to that are the difficulties of relentless treatment. If the sickness is pernicious, the treatment itself is vicious.
You must make all those minor and major adjustments, you must acquiesce and compromise, you must accept that your life probably will never be as it was. You can accept it with grace or you can fight it. But this is the real deal, pal: you can’t stay the same.
And of course, that’s what life is all about, at the end of the day. Forget the illusion of a continuing arc of achievement until we die in the lap of luxury. For most of us, that will never happen – our present success won’t help at the end. The smaller office, the less-luxury car, downsizing, painful joints, the ex-wife, the hated retirement, estranged kids, move to a furnished room, calendar filled with medical appointments, assisted living, the catheter or colostomy: a series of minor adjustments, compromises, large and small acquiescences, rationalizations. We can only hope that we won’t find ourselves on the downward slope of the hill without ever having enjoyed the summit. We will age until we become too weak to feed and care for ourselves, and we’ll hang on until one day we just . . . die.
* * *
As I watched people disappear from my survivors’ group, I began to feel like Barabbas, delivered from mine enemies – but at what cost? Some other cancer patient filled the statistical spot that might have been meant for me under the title: “Annual Deaths from Cancer.” The analogy of Barabbas haunted me – the thief chosen by his people to be free, the committor of seemingly “small” crimes, yet whose sins are greater than those of he whom was punished. The shrink at the infusion center had asked me whether I thought that cancer was a punishment (it turned out that, given the Judeo-Christian ethic, many people do). I looked at him as though he had asked me whether winning at the track were the Reward to the Faithful, and said, “Of course not – it’s just the luck of the draw.”
But my insomniac mind spun with these ideas, having little else to think about but my failing health and my business, which had faltered as a result of my absences. There was no religious significance attached to the idea of Barabbas and redemption, hardly any moral to be learned and little philosophy – only the irony of one man’s trial being greater than another’s, and that being the guy with the light end of the load seemed sometimes hard to take.
Of course, the light end of this particular load was still heavy indeed. I would live on, bearing the complications and having opportunities to change aspects of my life, trying to become happy at last. Is that how Barabbas reacted? Did he walk down that long hill in the light rain amid sunny patches, renouncing his thieving ways and resolving to live a truly happy life for a change, after a long-deserved vacation over in Hebron?
* * *
Interesting phenomena began to occur when the chemo really started to stack up in my body. The nature of most chemotherapies is that they are progressive and cumulative – the further down the line you go with them, the more they remain in your body and therefore the more they’ll affect you. I was getting my ass kicked with some true sincerity from the third through the eighth day – five or six full days of rat poison flowing through my system, twisting every human response into something quite unpleasant and scary, most accurately described as having a corpse shoved into your skin along with you.
I watched the slow progression, as the man who lived in the mirror lost his thick head of hair, then his beard. And then one day his mustache fell off. His features became harder and more severe, and I was reminded of a description of an old cavalry officer by George MacDonald Fraser: “He was a tough old file with a flinty gaze.” And that was who looked back at me from the mirror – a tough old file, one I couldn’t recognise.
So here I was, in the middle of my fifth cycle (having received chemo nine times) and the effects were just pounding me into the ground. I’m told that it’s something like a woman’s period . . . and so much more. I don't know if the effect can be blamed on hormones, but the wash of emotions I experienced was frankly stunning. Profound feelings of hopelessness, despair, fear, weakness, dependence, cowardice – all the things which my life had supposedly girded me against – would overwhelm me at odd moments and set me spinning to a snappy little dance number played by Death’s soloist himself.
There were times that I could hear Ironhand’s voice floating through the long tunnel from my childhood, repeating a joke he liked: “I tell you: first I was afraid I would die. Then I was afraid I wouldn’t!” I’d find myself longing for death as a way out of the pain, then I’d chide myself for such silly thoughts. There was logic lost there – I was, after all, undergoing this pain to avoid death. But the mind does funny things. On certain days, in certain hours, it all just seemed too big to cope with. I was reduced to the outlook of a little boy – a scared and vulnerable little boy, stripped of the years of training in becoming a man, in hardening himself to the difficulties of life. I was a little boy who felt no shame in crying.
And in those moments, somehow, I learned what strength is – not what we believe it to be, or what big-screen heroes show us, or what we want it to be or need it to be – what it is. Strength is forever allied with faith: the faith that we can get through, if we can just hang on. The child can believe, and persevere, perhaps because he has not had all that training in becoming a man.
And then the realizations start to come. A clarity takes over which peels away all the happy horseshit and the clichéd beliefs we spoon-feed ourselves every day. A man can look at the bare face of life and learn his lesson, without fanfare – and, if he’s lucky, without regret.
To really accept being the essence of a man relates back to several archetypes, one of them the failing father, the man looked down upon by the son for not being as good as the son has become. But how could he be? How could the father – over and over throughout time – consistently be better than the son? First, nobody would like the effects of that. Objections would be raised. And more important, it defies evolution. Each generation must improve, if a species is to survive. Sons must become more – and better – than fathers.
And we can’t forget the partner and the mentor, both archetypes with very necessary social functions. There is more to mating than the act of procreation. The joining of two lives involves a variety of small relationships stacked into a larger, more penetrant and encompassing relationship with the same person – the partner. And the mentor is a friend and teacher, one who guides the younger person into and through the confusing labyrinth of social and natural relationships. These facets of adulthood – and, by extension, of manhood – are secondary to the relationship with self, but they are crucial for an individual’s healthy functioning.
There is also the laudable trait of just being there, a solid post in the community to lend a hand when needed, or perhaps to merely be a witness – the good neighbor, another often-overlooked archetype. The truth is that we don’t need as many heroes as we need men who will admire them. And why do we admire heroes? Because we’re ordinary. As special as each of us might be, compared to heroes we are only ordinary. So be it. The descent into ordinariness is another facet of strength.
The true strength is this: We go through our lives, learning our lessons and taking our knocks, often never realising that this is all there is. No redemption, no third act, no flashing moment of enlightenment: just more of the same. Just our own ordinariness, the diminishing strength, our incipient weakness, until we fade or fall away.
And that’s what being a man is about. That’s where a man’s true strength – his real beauty – is found. To be able to keep pushing forward, knowing that there are no more accolades, no more big kills, no awards or golden moments, no endless summers. To accept that and to stay focused on just reaching the goal when all the glory is behind you, to keep showing up, suited up, long after you haven’t got a double-play left in you – that’s the strength of a man.
Maudlin? Certainly not. Delusional? Maybe. Foolish? Probably. But nothing flies for long without coming to ground. We’re all going to be there, coming to ground, and each one of us must sooner or later face that certainty. To glide gently in with grace and élan makes a much better story than to crash and burn, a million biker tattoos notwithstanding.
© 2012 Hakim - ALL RIGHTS RESERVED: use without profit allowed only with author’s express written permission. Please don't wake up my attorney. Please.
jueves, 4 de abril de 2013
Part 2: Local Man Still Hopes to Bring his Family Home
Carter ‘Hop’ Cowan sits in a coffeeshop in Berkeley, taking a scant few minutes off from his day-long search for work and still wishing that he could have brought his family back to the States when he arrived a few days ago. But the sea captain’s course back to his homeland was in some ways a rougher ride than crossing the Pacific Ocean from Cebu, Philippines, where he lived for years with his wife and 14 year-old son.
“I’ve come this far, really struggling to get back to the States so I can work and send money home for them – and now the work really starts. I feel better though, since I’ve managed to overcome all the obstacles to get here, so I’m hopeful that I can do what’s needed to manage our lives here,” Carter says, looking very determined as he jots down ideas and possible leads for work.
|Vivian & Carter in happier times|
But his eyes soften when he speaks about Vivian, his 49 year-old wife who currently suffers the devastating effects of late-stage cancer. “I hated leaving Vivian there, but it seemed the only way to get her family involved. And my life wasn’t safe if I couldn’t pay our bills. Some old injuries really kept me from some of the jobs I used to do, and I couldn’t keep a work visa in Australia. It was humiliating to leave like that, but as soon as I can send money back, I’ll begin to feel better about the whole situation.”
Broke from the medical bills, Carter faced a practically non-existent job market in the Philippines during the world-wide crash of 2008-2009. Watching his wife suffer became too much for him, and friends worked overtime to get him back stateside by a lengthy campaign with the US State Department and the US Embassy in Manila.
Impoverished by medical bills, Carter couldn’t even leave the Philippines til someone helped out with the money to fly 355 miles from Cebu to Manila, where the US State Department indicated that it might lend him the money for a ticket home. His circumstances deteriorating daily, Carter was able to get several American friends to push through for him. “Now I’m here in the Bay Area, and I’m aiming to find a job – and I don’t care that it’s a declining market. There’s a job for me and I’m going to find it!”
Asked about his earlier claim that he’d “find a way to sail us back to the US if [his] boat were seaworthy,” Carter shows that tough and salty side. “I’d never abandon a boat that could safely sail. And taking a sick person across the ocean isn’t optimum – but I’ll tell you, I was desperate enough to try anything. Yes. Yes, I would have set out with nothing but water and plain rice, if we had enough medicine to make the trip. I know the Pacific well enough. But it’s a different course now – now I have to earn and send, earn and send. I’ve done it before, and I’ll do it now.”
While it seems a long way off, Carter still is determined to get his wife here, along with their son Hopkins, who is a top middle-school student. “Hopkins has seen what a catastrophe medical bills can be, and he’s studying hard to build himself a career that will allow him to care for the family he hopes to have one day. So perhaps this whole incident has had a good effect somehow.”
Unable to raise enough money to help bring the family back, Carter’s friends turned to the US State Department and even contacted the Red Cross on his behalf. They recently found some money held by the state of Virginia in Carter’s name, but that’s only a few hundred dollarsthat may take months to recover.
Carter’s years at sea are evident under a gunmetal Berkeley sky – strength, tenacity and indomitability. Determined to get his wife to the States for treatment of the cancer threatening her life, he’s tired but unwilling to give up for the day.
“Got to get back to it,” he says, and heads out into the wind to walk to the marina to look for a job, any job – leaving an observer to wonder whether Carter still has the strength to keep going at his quest.
Readers can send advice, encouragement, or prayers to: Captainswife44@hotmail.com.
Donations may be sent via PayPal to: Captainswife44@hotmail.com.
To read Part 1, go to March 13th.
To read Part 1, go to March 13th.
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David Hakim is an internationally-published journalist and award-winning author who has run several newspapers – and recently received a commendation for his short story That Man in the London Aesthetica Competition. He can be reached at 415.378.6170 or firstname.lastname@example.org