day 69 giving thanks, connecting and taking stock

I didn’t grow up with Thanksgiving, being German and spending much of my youth in England. There were harvest festivals of course although my family did not observe these ancient celebrations of thanks for bringing in the food for the year. I have come to enjoy Thanksgiving in the US over the 20 years that I have lived here, as it provides an opportunity for reflection, connection and taking stock. Reflection on what we have to be grateful for, connection with our loved ones and taking stock of where we are in our life.

Reflecting on what I have to be grateful for at this moment, is not hard. First of all, I have a great family around me that supports me and takes care of me. Then I have what Teddy Roosevelt meant when he said “Far and away the best prize that life has to offer is the chance to work hard at work worth doing” with my job at MD Anderson. Particularly pertinent at the moment, of course, is my gratitude for the care my doctors and their talented teams provide me. But I also recognize that I have a privileged life by which I mean being born into the middle class of a western industrialized nation at a time of relative peace (compared to the World Wars previous generations experienced).  I recognize that this start gave me great opportunity and security within which to seize it, and presented me with only the one great challenge – to not squander this opportunity, as it is not given to everyone.

To keep it real there are also a few things that I am decidedly not grateful for, with my cancer diagnosis at the top. I am not one who believes that disease is a challenge set by a higher being to test us and make us stronger. It is not a gift from above. It is the result of a combination of biological inheritance, environmental exposure and bad luck. It is best dealt with head on, and aggressively, and in as good a spirit as you can muster. It is also a chance to discover something about yourself and to make changes in your life, which can have positive lasting effects. But you won’t ever catch me thanking anyone for it.

Connecting with loved ones is an easy thing to say, and a surprisingly difficult thing to do, at times, and I am having a bit of a problem with it at the moment. I am experiencing what I am sure is a quite common dissonance between my inner and the outer world. Cancer by its largely hidden, semi-chronic nature can make the relationship between cancer patient and others complicated. At this stage I am neither in hospital, nor in bed or obviously ill. My hair is short (I cut it to get ahead of the inevitable loss) but otherwise there is no difference in my appearance. I go to work, and do my normal activities with the family. And yet I feel so different. There is the growing fatigue, which seems to be the dominant side effect for me and makes me feel slow and old. I went to the Museum of Fine Arts Houston this weekend to see the spectacular War/Photography exhibit – I am a huge fan of photography – and had to sit down every few minutes. Then there is the persistent and bothersome numbness in my feet and the clumsiness that probably comes from both this and the fatigue. Then there is the inner voice that reminds me all day that its different now, and that layers in an internal comment or two when things occur that trigger dark or ironic thoughts. I think the one thing that cancer changes is how you feel about your own mortality. It is definitely a wake up call, and one that rings incessantly, at least for a good while. It makes it hard to connect with those around you who have not been there, especially if they are unable or unwilling to acknowledge the change in you. In this regard I feel fortunate that my wife, a 5-year survivor of breast cancer, is always there with me in that same place, and that we can connect with just a look and no need for words. But it makes the holidays a challenge when the expectation from society is that you are full of cheer.

Taking stock is more than I can do here, and do now. The impact on my life, and my perspective of it is not yet clear yo me. I am still too much in the thick of the fight and will be for some time. What I do see is that I feel a new sense of urgency regarding my personal and professional goals. Also a  desire to focus on what is important. (I have been working on the resource for male breast cancer that I have written about and making some progress.) Sounds like platitudes to me too, but it is perhaps the bright side of that inner voice that tells you everything has changed. Because it has.

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