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If you can fill the unforgiving minute ... with sixty seconds’ worth of distance run ... Yours is the Earth and everything that’s in it.
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Monthly Archives: January 2009
Like almost everyone who reads this, I am a runner. Runners come in all different shapes and sizes, and come from all different sorts of backgrounds. I am your typical life-long, ex-competitive runner. I began running for soccer and figured out quickly that while I was only an average soccer player, I had above average speed. I joined the track team and amassed some very minor local success at the sprints. I went on to college and there I took up long distance running. I fell in love with the rhythm and the loneliness, the connection with nature. I spent many days out in the woods, running, writing my philosophy and history papers in my head, hurrying back home to spill out the great thoughts came to me while engaged in that simple and majestic act of gliding through the woods.
I kept running through law school. I was so caught up in the spring of 2005 with writing for the law review, studying for finals, and preparing to graduate that I barely noticed the first signs of the Beast: the ever so insidious slowing of my pace, the ever so slight tickle in my chest, the fact that I would sometimes wake up with a few spots of sweat on my shirt. I kept running through the bar exam. All the long summer of 2005, I ran infinite laps around the high school track with my ipod strapped to my arm, headphones stuck in my ears, listening to lectures about contracts, con law, torts, and property. After weeks of struggle, I suddenly just “got” the Rule Against Perpetuities while jogging slowly past the home stands one morning. Another day I had a similar sudden running induced epiphany over the parol evidence rule while stretching after a seven-miler.
I ran through the protracted hot days of the bar exam itself, rising before the first blush of midsummer dawn to jog through the quiet streets of Columbus. I kept running through the summer and the fall as I looked for a job. As I started to put my adult life together, the Beast strengthened. The day I went to get sworn in as an attorney, I went for a run very early in the morning and coughed up a little bit of blood. Another time just after beginning my new job, I had to quit running because of a hacking cough. It’s allergies, I said, or it’s acid reflux. It was none of those things. It was the Beast.
It was a terrible pain in my neck and shoulder that finally led me to my doctor’s office. And so I found myself almost exactly two years ago today going through a surreal, terrible process that hopefully no one here ever experiences: being diagnosed with what the scans said was unquestionably advanced stage cancer, with the only ambiguity being the precise variety. In the span of a week, I traversed the roller coaster. There was a screeching, terrifying, dash down into the depths of despair after being told the likely diagnosis of the “very large and inhomogeneous mesenteric mass” that was crowding out my left side was a kind of rare primary inoperable liver cancer -- prognosis "checking out soon" as my oncologist frankly put it yesterday. Then there was a surging ascent -- that brief, but utterly relieving peak of having the biopsy finding miraculously be a kind of cancer that is potentially curable. But then there was a horrible precipitous plunge down into despondency again upon learning just what treatment entailed and just how grave my case was at the moment.
It is curious how swiftly your life can change. In the course of approximately a month, I went from being a young trial lawyer whose only medical experience was a class in anatomy and physiology and a little bit of biology and chemistry in college to learning the intricate details of an alphabet soup of seemingly randomly arranged letters that innocuously represent toxic treatment protocols – ABVD, BEACCOPP, Stanford V, MOPP. Where as I had thought it a colossal catastrophe to have a case of knee tendonitis, I now rapidly found myself trying to comprehend conditions associated with advanced stage cancer that I had never even known existed -- afflictions with ominous appellations like tumor lysis syndrome and SVC syndrome.
All bluster and bravado aside, I think it was a minor miracle I even survived the initial blast of chemotherapy. The cancer had shoved my stomach to the side, pressed down on my left kidney, compressed my pancreas, and formed a large firm mass that stretched from the bottom of my rib cage down to my hip bone, and all the way across to my navel. In my chest, the masses were pressing on my heart and lungs, forming effusions. The vein that drained the blood down from my head was partly occluded, the nerves in my shoulder crushed. My cancer is treated with out-patient chemotherapy almost exclusively, but my oncologist firmly insisted over my protestations that I be hospitalized for my first treatment and he turned out to be exactly right. Those were the three most miserable, awful days of my life.
But I somehow made it through that first dreadful weekend, and I was back out running around my block within days, even if I was so dizzy and so lightheaded that running twenty steps made me seeing black spots and forced me to a walk.
I also somehow managed to successfully navigate through eight grueling months of chemotherapy -- every other Friday, sixteen times in all, for eight months. My oncologist is soft spoken, but he took an absolutely unrelenting attitude towards my cancer -- his plan was to bludgeon the Beast into submission with a very extensive course of chemotherapy. He steadfastly refused to shorten treatment, even when my first scan was surprisingly good. I began to think that any lingering cancer cells wouldn’t dare stick around knowing that my oncologist was there. I have a good sense of gallows humor and imagined the diminutive undying marauders crying out, “Uh oh. There’s that little Aussie guy with the nukes. He may speak softly, but he carries a big stick. Let’s get out of here!”
Through that interminable eight months of poisoning, I kept running, although less than before. But even when the chemotherapy attacked my lungs and left the right one scarred, I kept going.
I became a cancer survivor when I was diagnosed with stage III/ IV Hodgkin’s Disease on February 14, 2007 at about 11:38 AM. Being diagnosed with cancer was the tragedy of my life. I still find myself staring at the ceiling at night in the dark, listening to my heart beat, unable to silence the raging demons in my head. Life as a young adult cancer survivor is difficult. I have had people say I am strong, that there is something inspirational in all of this. I appreciate the thought, the kindness that is being conveyed, but really, I am not that much stronger than anyone else, I think. I certainly seem to be a touch more stubborn than most, and more than perhaps a touch crazier. But, I think all human beings have the will to live and survive -- a little ember that burns brightly in everyone. When people say I am strong, I feel a touch like I am tricking them with some exterior persona. I want to stop them and say you think that I am strong, but you wouldn’t think so if you saw me fretting over how I am going to pay my bills. And likewise you wouldn’t think me so brave if you would see the clench of my fist or the damp cold droplets of sweat on my back as I brace for an IV -- did you know I am scared of needles? You also certainly wouldn’t think me so stoic if you saw my simmering anger at how unfair this all seems. And most definitely you wouldn’t think me so inspirational if you knew there were days during treatment I went home and just cried for what I had lost. So, you see, I am no stronger than anyone else. I am just a human being, trying to survive my circumstances, trying to do the best to play the game with the particular hand I was dealt.
I’ve also had people try and tell me I have a good attitude and that matters, and I appreciate the thought, but really … cancer is such a horrific disease and it cares nothing about you -- who you are, what you do, what kind of person you are -- good, bad, indifferent. This isn’t easy, this isn’t a movie, this is my life. I know there may not be a movie script ending. Cancer boils down to a random, genetic mutation where you have cells that just divide uncontrollably and refuse to die. I was fortunate to have a cancer that was curable even in the very last stage. I was fortunate to have an oncologist and a medical team who knew what they were doing. And I was also fortunate to be a runner. And I will tell you here -- my fellow runners, I do think that made a big difference. It would not have saved me from stage IV liver cancer, but it did offer me the physical and mental tools to overcome what I was diagnosed with. Do you know those runs on days you don’t want to do it? Hopefully you’ll never have to find out the way I did, but the truth is they teach you to persevere in ways you never dreamed imaginable. And do you know those runs where you don’t know if you can get through because the miles are going by so slow? They teach you to take things one step at a time, if necessary. When the enormity of my cancer overwhelms me, when I feel like crawling under my bed to hide, I call on the discipline and perseverance ingrained by many miles on the road.
And, although I am not sure if I believe in any higher power, I think just perhaps I was given an extension of time for a reason. I vacillate between believing there is just absolute randomness to the universe to considering that just perhaps I am still here for some unknown reason.
And truly, I can say although I would never wish the nightmare I have endured upon anyone, having cancer has been astonishingly life affirming. Take, for instance, simply having to undergo chemotherapy. Certainly a terrible, horrendous experience. Oncology even in the 21st century is still a brutal discipline; the intelligent, talented, and compassionate people who choose to become involved in the terribly trying and difficult crucible that is the practice of oncology are forced to subject their patients to noxious chemical concoctions and burning radiation in a Faustian bargain to try and coax a cure in some and alleviate suffering in others. And yet out of the abject horrors of the arduous experience of chemotherapy, I can most assuredly say that the most beautiful and profound phrases and words that have ever passed into my mind have been uttered in that room, by patients suffering alongside me.
I’ve developed my photography greatly since being diagnosed with cancer as well. In fact, I've grown to love photography, to find a sort of existential healing in trying to capture the beauty of the natural world. Things other people pass by draw me in; having flirted with the real possibility of “checking out early,” I have a desire to live like Thoreau, to suck down the marrow of life, to find happiness and beauty in every creation.
I also don’t think I ever knew what it really was to love running until I found myself lying in bed on a beautiful spring weekend morning, lingering in the hazy cloud of fuzzy sickness that followed each blast, merely yearning to engage in the simple act of lacing up my shoes, to feel the dirt underneath my feet, to run under that impossibly blue sky, to just run, not for time or because I have to, but because I wanted to run. I promised myself then if I made it through to the other side, I would run many, many miles before it was time for my last sleep.
I used to struggle to wake up early to run. But now almost every day, I wake up in the darkness of the early in the morning to the alarm on my cell phone, sit bolt up right in bed, take as deep a breath as my chest will allow that day, smile, and feel a small bubble of joy rise up in my chest that in a few minutes I will be up and running, even if it means running endless laps around the tight turns of an impossibly tiny indoor track. For yes, even a run on an impossibly small indoor track can be a gift, depending on your point of view.
Yesterday, I found myself again sitting in my oncologist’s office, in the exact same exam room I first met him in back in February 2007. It was like coming full circle; I was diagnosed during a huge snowstorm, and yesterday I was sitting in my oncologist’s office on a day of an almost equally large snowstorm. It has been twenty-four months since I was diagnosed with cancer, close to twenty-two months since I first heard the word “remission,” sixteen months since I finished chemotherapy, and I have to honestly say it feels like it has been a lifetime since I did not have cancer. Despite achieving remission via one kind of scan (one that measures metabolic activity), my CT scans have grimly coldly revealed scar tissue masses of grapefruit size scattered throughout my chest and a spleen that has never quite returned to normal size. This has always been worrisome. But this time when my oncologist handed me the report, I could see it was genuinely good. The scar tissue masses are still there, but they haven’t grown in over a year. They are now actually calcifying -- petrifying into cold and stony dormant remnants of once hotly active lymphoma that seriously threatened to choke off my superior vena cava, crush my windpipe, and terminate my existence. My oncologist told me the scars probably will always be there.
I suppose there is something fitting about the fact that my scans will always show the scars, the reminders of my fight, for even if I’m fortunate to live another seventy years somehow, I will always be a cancer survivor.
But I couldn’t help yesterday to feel hope ascend into a little burst of joy. I know my odds are about 50-50 on cure given my presentation and the extent of my disease. If I can make it to October 2009 without a recurrence, then the chances that the Beast will return are very low. And so every day that passes gives me hope -- hope that the Beast has been bested. Hope is such an extraordinary, dear thing. Sometimes I found my hope would flicker like a candle, teased by the wind. Other times, like today, I find the flame burning bright and strong. Hope, and running, are both gifts -- and so even if it means circling a tiny indoor track, I will not waste the opportunity and the moment -- I will not waste this gift of cherished time to keep promises and run many more miles before I sleep.
I slip out my front door from the warmth and light of my house into the dark coolness of the very early morning. Tiny stars glitter like tiny diamond stud lights scattered in the heavens. I stride to the end of my driveway, then ease into a trot.
The air feels stunningly cold as it hits my lungs; when I exhale my breath hangs momentarily in space as a white cloud. My pace is easy; I am not quite awake yet and am still shaking out the early morning cobwebs from my mind as I glide over the fallen snow.
I make a turn down a side road, being careful to watch for icy spots. When my foot makes contact with the snow, I can hear the soft, distinctive creak that sounds like walking over Styrofoam. Now heading due east, I notice a silver crescent moon hanging over the horizon, a tiny sliver of dazzling light cut out of the black sky.
Another turn, and I have slipped into the woods. It is still dark, but already the brilliant brightness of the stars has begun fading into the deep violet that precedes the new dawn. But for the moment it is still quite dark, and I’m reminded of the famous Robert Frost poem, for indeed, these woods I travel through are lovely, dark and deep. But like Frost’s protagonist, I do not pause, for I too have promises to keep and many miles to go before I sleep.
As a trail runner, I’ve always appreciated Frost, as I imagine many runners do. When I was diagnosed with cancer, however, that particular line about having miles to go before I sleep took on a special meaning. There were those really bad days when I went through chemotherapy where I just existed in that sort of hazy, amorphous world that lies somewhere in between life and death -- a dark place where you are just too sick and too fatigued to really even care about anything more than trying to make it to the next moment. But even on those days, I would find there would be moments of sharp lucidity where I would find myself day dreaming, eyes fixed out the window, wishing I was out running. I promised myself if I made it through to the other side, I would run many, many miles before it was time for my last sleep.
And so, just about every morning before work, I am running. Not because I have to, or because there is a race to train for, or because someone told me to do it. I am there because I love it. I run every day chasing that elusive feeling of gliding along, effortlessly, soundlessly.
I was diagnosed with cancer on February 14, 2007. It has been almost two years since I was diagnosed, 21 months since I entered remission, 16 months since I officially finished chemotherapy. There are actually times now where I sometimes get so busy with work that I forget I ever had cancer, where the fear of relapse sometimes actually recedes so much that I don‘t know its there. The majority of nights I can fall off to sleep quickly -- those dreadful nights of spending endless hours in the dark staring at the ceiling, listening to my heart beat inside my chest happen pretty rarely now. But then, like this week, I have to go for a “restaging scan” -- basically a scan to check and make sure that the Beast has not returned. The dread, the apprehension, comes roaring back, rising up like hot acid, burning the back of my throat. There is a special kind of terror in going to find out when you feel perfectly fine whether there is indeed something again insidious lurking in your body that will destroy the life you've so carefully tried to piece back together. It is one thing to feel sick and be looking for a cause, and a solution. It is another altogether to go seeking trouble. And so, I am distracted again, fearful if what the morrow will bring.
Fortunately, like the last one, my monitoring scan was “stable” which means the findings were “consistent with treated lymphoma without sign of progression.” My scans are never unequivocally “clean;” if you could peer inside my chest you would see the now dormant, calcifying remnants of scar tissue that once represented an extremely serious case of very active Hodgkin’s Disease that threatened to choke off my superior vena cava, crush my windpipe, and end my existence. Like my mind and my soul, my physical body will never be entirely free of the reminder that I had cancer.
But for now, the Beast remains dormant and dead, and so there will be time to keep promises and run many more miles before I sleep. And so this morning, I was back out running again, in the cold and the inky darkness, keeping that promise I made to myself when all I could do is lie on my back and gaze out my window at the world that went on without me being a part of it for approximately eight months. As I finish my run, the first red blush of dawn has washed over the sky and the star and the silvery crescent wisp of a moon have disappeared in the gleaming colors of a new day filled with promise. As I bound up my stairs and back into the cozy warmth of the house, the sun has risen just above the trees, a huge red ball casting reddish shadows of light on the bright white snow. Granted a blessed reprieve for at least another three months, until the next “restaging,” I head into the house to get ready to head out into the world again.