Tag Archives: mortality

Little Leaps, Big Bounds

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Cancer moves exponentially, starting slow as invisible mutated cells find homes (unlike in functional bodies where they are peed out into oblivion) and then the mass or masses take off like that hopeful snow shape in a palm

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that suddenly emerges as an obvious ball worthy of throwing or further building towards a snowman’s torso.images-1images-3

My cancer went from delicate growth (September/October) to a small bound (today). The news comes on the heels of more daunting recoveries from my most recent treatments. My husband scurried from one futile effort to the next to bring me comfort this last cycle, his only reward my teary confession that I wasn’t sure I could continue this path. It felt too hard and, in fact, stupid.

Yesterday and today I feel good (yahoo!) but the news is the cancer is feeling good as well. It’s on the move.

Who to call? What to do? I rollback over my choices, as my personal doubts mount, and recall, “Oh yes, I had to play my big card back in June when the cancer surged so fast.” But I played that big card. The cancer continues to play its hand. My hand holds few backups outside of hoping that the waiting line for UPenn moves fast and that I qualify for a trial slot sooner rather than later (or never).

Uh Oh

Decent

Uh Oh!

Uh Oh!

Last week, I wept at the thought of enduring the back-to-back-to-back-to-back chemo days required by the UPenn protocol – HOW COULD I FACE THAT after these unrelenting five months of aggressive treatments. Today I want to book my flight to Phillly, elbow my sisters off the line and demand the start.

What odd creatures we humans are; or is it bigger than humans this quest to live?

I recall my last dog, Tony, in significant decline as he aged. Was he 16, 18? I didn’t know but he and I partnered in life for 15 adventurous, full years. Then he was deaf, dumb and blind, increasingly incontinent and having micro strokes. His rapid decline timed poorly with my terminal diagnosis. I wasn’t feeling well positioned to pull the plug. I decided as long as his tail wagged, his life was worth living. His tail wagged.

The vet gave me pills a year prior when she diagnosed the micro-strokes and a litany of other poor health omens. She inferred that these could be given for pain management (he wasn’t showing pain) or, hint-hint, to bring things to a close. Oh! My! In July of 2012 strokes left him barely able to walk beyond small circles. He stopped eating or drinking. I gave him every form of permission possible to die and started the pills. He lived. I increased the dosing and another day passed. This was like some very bad, slow moving skit. One night I gave him all the remaining pills, said my deepest levels of goodbyes only to awaken to a living dog and a husband declaring, “we are going to the vet now.”

The vet euthanized Tony – outside, on a vast lawn, on a glorious day. Tony, to the end, resisted. The vet said this was typical of dogs. Now I wonder about me.

Diem Brown was one more reality star I would never have encountered if she wasn’t plagued by recurrent ovarian cancer in the years prior to her death this past weekend at age 32. Two things struck me, again. One, how vibrant she looked mere weeks before dying despite surgeries beyond imagination. We want the dying to give us the courtesy of looking the part. It is the only way we, the outsiders, conceive of what is going to happen next. And then her last tweet, defiant, forward looking despite the cancer having engulfed her body as she swears,  “My doctors are seemingly giving up but I won’t & can’t rollover. Whatever option I have to LIVE I’m grabbing!”

I see this in my peers, regardless of age – at 82 and 32 – I see this commitment to life at all costs. And then there are the elegant exceptions. It’s a very big gray zone. Fighting vs. caving vs. bowing. Life is indeed a balancing act and the guidebooks rather vague.

“Enlightenment is always there. Small enlightenment will bring great enlightenment.” Thích Nht Hnh

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A Look At Envy

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A former colleague joined the recurrent Ovarian Cancer club recently and we have re-connected in a sisterhood far beyond tax fairness. We accept our reality while exploring every avenue for slowing our walk towards death. She wrote a poem I share below. I, with recurrence in 2011, relinquished my envy of old age as I focused on living long enough to turn 60. I have friends who would love to reach 50, or 40, or 30 and suspect they will not. As a child the first phrase that I was ever motivated to memorize was, “I cried because I had no shoes until I saw a man with no feet.” But admitting what we envy is to be human.

Before dying at age 44, a friend interviewed “little old ladies” so that she could experience that future knowing she would never live it. I loved that problem solving just as I love Sandra’s clarity with words.

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Old Age Envy by Sandra Morgen

Envy unleashed:

walking past a man in his 70s

hauling himself down

an uneven path

before summer heat

boils the morning.

Last night

under a vine maple

lit by a gibbous moon

the silhouette of

a couple in their 80s

her blanched hair escaping hairpins

his back straight with effort

frail fingers knotted.

I used to dread old age

imagining loss, dementia,

fading, being a burden.

Cancer trumps those forebodings

incubating envy

but not resentment

an aching appreciation

of what is unlikely to be.

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Reporting In

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Some periods of time are too dense with experiences to narrate. Add in the sharpness of the struggles, their lack of resolution, a heat wave, a chemo cocktail designed to knock you on your ass and a bit of silence might ensue. My focus is on putting one step in front of the other. Surviving.

The good news is we are surviving right now and still imagine August as a calmer month. Perhaps I will have vignettes to share then. I pack for my third trip to NYC since June 21st. This trip I do solo, despite my husband’s protests. With an uncertain travel future looming and mounting costs, I need to know that I can make whatever path I follow sustainable.

The last trip really felt vacation like even if we never got much beyond the infusion suite.

This trip will be down and dirty. I will be late to arrive, early to leave, just getting in my 29 hours of infusion time. Turned away at the deluxe, free cancer housing in midtown Manhattan with a terrace to delight

Me, reclining with chemo overnight bag pumping away, on the cancer terrace.

Me, reclining with chemo overnight bag pumping away, on the cancer terrace.

and a waiting list to match, I got adopted by an old colleague in West Harlem – a touching kindness and a treasured connection to my non-cancer life.

In lieu of truly filling you in on the now, I offer a brilliant short piece written by my first cancer pal, Bev. She has offered me solace as I learned to live with terminal cancer. This week she entered hospice. She will leave this world with a bit of my heart. Enjoy Mystery Bag, a little peak at living with cancer.

Mystery Bag by Bev Lipsitz

I was in a writing group for women with cancer. One day, the facilitator brought in a bunch of paper bags. She told us to pass them around and without looking, feel inside each bag.

Then she gave us each our own bag, and told us to reach inside,  and still without looking,  write about what we found.

When I felt inside all the bags, there was only one item I could identify. It felt like a swizzle stick. I thought I might write a story about a wonderful vacation in Hawaii.

But I got a different bag, with something I couldn’t identify by feel. Hmmm, what to do next…

Let’s try a CT-Scan. Fill the bag with contrast.  Lay it down and slide it in and out of a machine that looks like a giant donut.

Click, click. Breathe. Hold it. Breathe. Hold it. Click, click.

Sorry bag, the pictures show that it’s cancer.

Oh no! Now what do we do?

Surgery! Slice the bag down the middle. Take the damn thing out. When you’re done, staple the bag back together.

Oh this thing is ugly. Can we learn anything more about it? Sure…Slice it up. Send samples to the lab. The report comes back: its OVARIAN cancer. OH NO, everyone says that’s a bad one!!!!

Did we get the whole thing out? Leave any pieces inside? What if there are some crumbs that didn’t get out?  How do we get rid of those?

Chemotherapy! That should take care of it. Pour some poison in the bag.  What’s that? The poison burned a hole in the bottom. Anybody got any tape?

Oh by the way, even if this works for now, this cancer could come back. We might have to do this all over again…and again…and again…

This bag is a mess. I wish I had gotten a different one, maybe one with some candy in it, or a brownie.

You know what, though? This bag is stronger than I thought. Even with the cancer, and the poison, and the staples and tape, this bag can carry a lot of stuff. Don’t worry, bag. If that thing gets too heavy for you, we’ll bring in reinforcements. Wrap you in a blanket. Make you comfy cozy. Sit with you. Don’t be afraid.Unknown

 

Thank you, Bev, for your clear way of looking at our lives. Dont be afraid. love always, marcy

They Found My Uterus!

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It’s been a sobering week. Did I expect my cancer to return to visible status? Yes.

I thought it would wait through the summer and I never considered it would return in an immediately life threatening way. But it did and I get the situation.

My response was action since I still hold out for obtaining the greedy age of 72. Between my new physical realities, deep sadness and coordinating three major cancer centers in three states, even with great helpers, I was exhausted. Yesterday my only task was to get to OHSU and piss in a cup. And I said “no.”

I opted for a chair in the gorgeous sunshine, perfect breeze and faced my grim reality with my heart not my head. I might just have to say goodbye.

My husband intuited my reality and arrived home early. We sat together and talked end of life issues. It was lovely. It is what is within our control. The mood was deep and yet light and oh-so-tender.

This morning I awoke to an emailed copy of UPenn’s reading of my ct scan of last week. One issue I had had was, “where did my uterus go, when did I have a hysterectomy and why a vaginal cuff?”

Where is Marcy's uterus?

Where is Marcy’s uterus?

But when your belly is full of cancer, you let go of the esoteric questions. The vast majority of women with ovarian cancer have a full hysterectomy as part of their debulking surgery. I did not. For some reason when I transferred to OHSU they decided I had a hysterectomy. It’s led to a little chaos like being denied a pap smear because I don’t have a cervix. I don’t. How do you know that? I think I have a cervix. Who snuck in and grabbed it and why? These are the kind of mess-ups that entertain me too much.

So, I have wondered out loud about these missing body parts. It’s just so perfect: “Grief Stricken Woman Loses Uterus.” A deserving headline for somewhere.Unknown-1

And then this morning at 7 am UPenn informed me that they found my uterus. It is just where it is supposed to be! I have a cervix, no vaginal cuff and, sigh, still a belly full of cancer that they declared having greater spread then OHSU. You win some. You lose some.

I sit with my grief in my heart, it is very real, but I refuse to lose my wit and sense of what I love about being alive.

As I pack a suitcase full of pills for my Monday travels, I sigh at each new bottle that offers to offset some side effect of treatment. I will come back feeling much more poorly. These drugs help and hinder. I pack not quite believing that my short break is over but knowing that if the sun is shinning when I am in NYC that will be enjoyed lavishly by me because that is within my control.images-1

Good Deaths, Good Dying

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The opening line of my friend’s sister’s obituary moved me with its gentle force. The sentence named the deceased, summarized a few of her accomplishments and then announced that she had, …”peacefully ended her own life at her home on May 20, 2014.” The photo shows an attractive woman brimming with life. She decided how to cope with her diagnosis of Alzheimer’s Disease when diagnosed four years prior. From what her sister narrates, and another lovely photo captures the day prior to her death, this woman decided to have a good death.

Beloved sisters saying goodbye.

Beloved sisters saying goodbye.

A good death is not that easy to come by. I am no expert but I have been in the club of the dying for the last four years and I have watched quite a few deaths happen, more than quite a few. Labeling a death “good” or “bad” is risky but for me they seem to fall into those simplistic categories. A good death is the one we want. Right? We might vary in how we describe it with some imaging a dramatic ball of unanticipated flame as an ideal way to end it all but for most of us, the notion of having a period of closure with loved ones, then a selected few gathered around in a familiar and peaceful spot then taking your final breathes with no active pain or resistance seems ideal.

It should be easy to stage a good death but neither life nor death is always amenable to choreography. Barriers to a good death include individuals not able to express a concrete vision, usually because they don’t have a safe and encouraging circle within which to plan, let alone not living in a society that accommodates such choices – individuals, community and society.

I watch another friend journey towards a good death. In March 2014 it was not on the horizon. By April she had a stage IV lung cancer diagnosis and a “treatment plan” of “morphine and home hospice.” By the end of May she started on oxygen. Her communiqués throughout never feature her diagnosis or prognosis. A woman of few written words she focuses them as the below sample shares:

May 21, 2014 sunny day-planted snow peas and asters

May 26, 2014 sun peaking in and I have plants to get in dirt

June 2 WONDERFUL FEW DAYS WITH MY COUSINS FROM WI SO WARM AND FUNNY AND JUST THE BEST!

I love watching her revel in every passing moment. Her cancer and approaching death she dismisses with a brief mention of her fear of pain as the cancer grows but her hospice team remind her of their skills and so she heads back out to the dirt, the view of the mountains and I appreciate that a good death is proceeded by a good dying support team.

Another day and another post will look at how a society can join this process.

What the Heck is Livingly Dying, Anyway?

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I strive to embrace livingly dying, a phrase I credit to the late Christopher Hitchens even as I co-opt his language. I see it as staring at imminent mortality and yet residing in the world of the living – finding the balance. How do you experience the concept?

Below I share a youtube that a filmmaker, Gerard Ungerman, made this past winter of me grappling with the topic as part of his Respectful Revolution series.

As you have a few minutes, please chime in with your perspective in the comment section at the close of this post.

The correct you tube is

https://www.youtube.com/watch?v=365W0sJq8BE

Another fine but unrelated one is here – I goofed in the original post  https://www.youtube.com/watch?v=6OK8Nut6y1U

Warmly, marcy

A Friend, Indeed

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One of my original friends in Oregon took on the role of advocate-in-chief when she heard of my diagnosis. She showed up the first night, phone to ear and stayed on the line until she got me the next available appointment with an oncologist. She is always there, often ahead of me in recognizing when I might need more hands-on assistance. She never waivers and has never said, “well, maybe….” in a way that makes me regret asking. She flew to Philly on her own dime for the trial intake interview. She is loyal and effective and most definitely the ‘secret weapon’ that coordinated entry into this clinical trial that required such pursuit.Marcy10:6:12

My diagnosis has impacted my circle of family, friends and colleagues in ways large and small. Holly, my advocate-in-chief, was a highly regarded political consultant when I was diagnosed. Now she is a licensed celebrant with a developing specialty in end of life support. (She is still regarded highly as a political consultant, it is just harder to access her time.)

Holly shared perspectives in the essay below, My Friend Marcy Has Cancer. I Don’t (Yet). Enjoy. Warmly, marcy

As a Funeral Celebrant and organizer of the PDX Death Cafe, death – and what happens before, during, and after – is on my mind quite a lot. And so I thought I should share an essay I started several years back about the big questions. The journal Cactus Heart was good enough to publish it this fall.

My Friend Marcy Has Cancer. I Don’t (Yet).9462551

I.

As the crowd of thousands marched downtown to the site of the Occupy Portland encampment, I left to run an errand. I’d been holding a handmade cardboard sign: “My friend Marcy is WAITLISTED FOR CHEMO – Thanks, Wall Street!”  Many of the people reacting to my sign – whether supportive or averse – thought I was the one waiting for chemo. Even the AP photographer who snapped the picture of my sign that ended up on Internet sites around the world asked, “Is that about you?”

They thought I was the one with cancer. In the coming days, I began to wonder.           

An hour after I left the rally, my belly began to feel like an air pump was inflating a basketball inside me. And I grew cold, so cold, despite my wool socks and heavy Guatemalan wool sweater. My teeth clacked and chattered. By the time I got home from my errands I had to unbutton the jeans that had required a tighter belt notch only that morning.

I forced my stiff, aching muscles up the stairs to my house and cocooned myself in a wool blanket in front of our fireplace. When the wracking chills still wouldn’t subside, my partner Amber found the thermometer. We were stunned when it registered 102.7 degrees. Must be broken. She took her own temperature – normal.

It was about 7:00 p.m. when I reached my doctor, who found it very odd: high fever and severe bloating, but no nausea, vomiting, or diarrhea, which you’d expect with food poisoning or a flu. We agreed that I’d try Tylenol and Gatorade and go to the ER if it got worse.

I woke up in the morning without a fever. But the bloating – I was still so unbearably full I found the idea of eating preposterous. I headed in to see my doctor. They took an abdominal X-ray and sent me home. Once they viewed the film, they wanted an ultrasound. I drove out in Friday afternoon rush hour having drunk the requisite 32 ounces of water – four tall glasses of liquid on top of the basketball in my belly. I was in agony.

I figured I ouldn’t get the results until Monday, but my doctor called and left a message around 6:00 p.m. It wasn’t a reassuring “all clear.” His voice sounded concerned. He told me to call him on Monday.

II.

Marcy’s unexpected diagnosis of Stage IV ovarian cancer had ripped the security blanket off our cozy community. In her early 50s, the poster child for effortless exercise and wholesome diet, Marcy exemplified clean country living. I had barely paused to admit my own emotional response to the pronouncement of her terminal disease. I had swung into action, attempting to impose order on this chaos by taking notes at her doctor’s appointments, organizing brigades of helpers, setting up communications systems.

The Monday morning after my ultrasound, I drove to Marcy’s house to accompany her and her husband, Mike, to see her surgeon, a highly respected gynecological oncologist on whom she had pinned her hopes.

During Marcy’s diagnosis 18 months earlier, Dr. C had gone in through her belly button to remove the small amounts of disease in her abdomen – debulking, they call it – but the cancer had already spread to her chest. Although the surgery and subsequent chemo had produced a blessed remission, her cancer holiday was over.  The disease was clearly on the move once again. Marcy’s meeting with her medical oncologist had left her in despair. She wanted the surgeon to offer something more aggressive, to deliver some hope through scalpel and sutures.

Marcy wore one of her trademark loose skirts. Despite her willowy dancer’s frame she had always favored prairie skirts that allowed her unrestricted movement (and she was constantly in motion). Just before her diagnosis, she had shocked all of her friends by favoring chic new slim corduroy jeans. But the bloating that accompanied her chemo had become, in cancer-speak, her “new normal,” and now it was back to skirts. I was wearing a loose skirt that day, too, to ease the bloat in my own belly. And to hide it.

Over the weekend I’d received an email from one of the national ovarian cancer listservs I had subscribed to, promoting the checklist of early detection symptoms we all need to internalize, like the monthly breast self-exam we were trained to do in the early days of the pink-ribbon movement:

Symptoms of Ovarian Cancer

–                Bloating

–                Pelvic or abdominal pain

–                Difficulty eating or feeling full quickly

–                Urinary symptoms (urgency or frequency)

I said nothing of my weekend worries to Marcy and Mike. An extrovert, I’m used to sharing (perhaps over-sharing) the details of my daily life. But not emotions – especially fears, especially existential fears of the sort that if spoken you imagine might obliterate you through their very utterance. Fears like: could two friends end up with the same supposedly rare cancer? Fears like: am I counting on my friend’s cancer to somehow provide me with immunity? Fears like: am I going to worry myself into getting cancer if I don’t already have it?

I was happy to stuff my own unknowns into the glove compartment for the morning; I preferred the immediacy of their fears to my own. I clamped down the impulse to distract us all with small talk or spiritual-silver-lining reassurances. We drove to the appointment in shared tense silence.

Marcy’s meeting with the surgeon delivered further devastation: he had nothing in his bag of tricks to help her. She fled the claustrophobic confines of the consultation room as soon as he left. I waited to get the paperwork and found Marcy and Mike in the parking lot. If I’d been unsure about conversation on the way there, I knew without a doubt there was nothing I could say now. Marcy was in full internal lockdown, desperate to be out of the car and back in her home doing the touchstone rituals she had devised to help her tolerate the intolerable.

As I pulled into the driveway she opened the door, “Sorry… rude…by myself.” She fled, with Mike not far behind her. I sat in my car getting her records release documents in order and offered a few inadequate words to Mike when he reemerged to fetch the documents. Then I pulled around the corner and called my doctor, expecting to hear reassurance in my ultrasound reading. Instead he told me there was a mass over my left ovary. He wanted an MRI to provide more detail. But first I should get to my gynecologist for an exam.

III.

Cancer World. It’s how writer Steven Shapin describes our modern existence in his review of the book “The Emperor of All Maladies: A Biography of Cancer” by physician Siddartha Mukherjee. Mukherjee calls cancer “the quintessential product of modernity.” Modern advancements mean more of us have cancer. We now outlive the diseases that killed our forebears before they had the chance to get the Big C. And the toxicity of our environment surely breeds more malignancy. How could it be coincidence that my father and his sister’s husband both died young of the same rare brain cancer, having shared no genetic link, only mutual employment in the family’s fuel tank cleaning business during my dad’s summer breaks from college and medical school?

Shapin, in The New Yorker (Nov. 8, 2010), argues that the modern impact of cancer goes beyond those who have the disease. He writes that historically, “The agonizing manner of cancer death was dreaded, but that fear was not centrally situated in the public mind—as it now is.” Shapin describes “two new kinds of beings in the modern cancer world.” One is the lucky patient who is now able to manage her once-fatal cancer as a chronic illness with miracle drugs like Gleevac. But Cancer World is also inhabited by the rest of us who are waiting and watching, “legions of the screened and the tested, who become more and more aware of the dangers battering away at their cells from the external environment and lurking inside, encoded in their genes.”

Just a month before my high fever and basketball belly, a surgeon excised a bad mole from my right tricep. The cells weren’t cancerous, but apparently that’s where they were headed. The mole is gone now, clean to the margins, but even in its absence, it increases my chances of developing a melanoma. So does the fact that my dad had a melanoma (separate from his brain cancer). And that my mom had another form of skin cancer, now known to be predictive of increased risk of the deadliest kind. My annual preventive visits to the dermatologist are now on a six-month schedule.

I’m a bit of an early detection nut. I’m not a hypochondriac (am I?); I don’t spend my time imagining myself filled with disease. But I don’t hesitate to call the doctor when I’m not sure what’s going on in my body. And I do every test they suggest.

I’m the daughter of a doctor, a man who knew he wanted to be a doctor as a young boy despite neither parent having graduated from high school. “He never went through the I-wanna-be-a-fireman-or-cowboy phase like the other little boys,” his older sister told me. “He just wanted to be a doctor.”

Thus I was born into my faith in the medical system. Not a blind faith: I believe that if you tell the doctor what’s going on, he or she will work with you to figure it out and will try to make you well or keep you safe. I have a strong sense of entitlement, being raised the daughter of a doctor, white and well-educated. They work for me, these doctors and diagnosticians. If I have questions, they will answer them.

And so I’ve been thoroughly probed and scanned and dissected. A lump removed from each breast in a procedure that strapped me to a narrow table, my arms pinned out to either side, crucifixion-style. A colonoscopy in my mid-40s. Suspicious moles carved out and shipped to the lab. X-rays, a CT scan, an MRI, and a PET scan to follow a nodule in my lung (nodule: another word for tumor, but writing tumor sounds melodramatic given its eventual disappearance).

And four years earlier I had been diagnosed with a bumper crop of uterine fibroids – inside my uterus; hanging from the outer wall on a stalk like a banana; embedded in the wall of my womb. Because I never had the heavy bleeding or cramping that plagues many women with such growths, the obvious solution, hysterectomy, seemed like overkill to me (fibroids are the leading cause of hysterectomy in the United States). But the bulk of my fibroids, equal to a six-month pregnancy, became tiresome. I felt obstructed from within when I did certain yoga poses, when I bent forward on my bicycle. My gynecologist warned of bowel and bladder difficulties; my chiropractor thought my breathing could be impaired and my skeletal system skewed.

I researched my options and opted for an embolization procedure to reduce the bulk without surgery. A radiologist inserted a catheter through my femoral artery and propelled microscopic pellets through it to block the blood flow from reaching the fibroids. I pictured them withering on the vine. A year later, my gynecologist reported with some amazement – she’d been a skeptic – that they had reduced in size by 50 percent, the optimal result expected from the procedure. Since then, I’d thought little about them, except during my annual pelvic exam as my gynecologist continued to marvel about the fibroids’ reduced dimensions.

IV.

The day after I accompanied Marcy on her futile pilgrimage to her cancer surgeon, I lay on my gynecologist’s exam table. She asked the question that seemed to solve the mystery of what had happened five days earlier.

“Did it feel like what you experienced when you had your embolization?” Yes, I realized, it was exactly like that. I don‘t know why it hadn’t occurred to me sooner. The procedure had involved an overnight stay in the hospital to control the high fever and severe pain that accompanies the death of the fibroid tissue when its blood supply is blocked. Now my gynecologist studied the original MRI that had guided the embolization and felt confident that it was consistent with the ultrasound that had alarmed the radiologist and my primary care physician. She would send both scans back to the radiologist to be sure.

It made sense to me now: some of the remaining fibroid tissue had gone into a death spiral. As it died – became necrotic, to get technical – the sanitation department kicked in. Fire up the incinerator (hello, 102.7 fever) and bring in the scrubbing bubbles of inflammation.

Still, I was relieved to get the call from my gynecologist three weeks later confirming that the radiologist had finally issued the all-clear. For now, anyway. The mass that had rung the alarm bell appeared consistent with the early pictures of the fibroids. But as with my dermatologist, my monitoring interval is now at the half-yearly rather than annual mark.

V.

My friend Marcy has cancer. I don’t. Yet. I belong to that tribe born of modern medical diagnostics: the precancerous. The Worried Well.7:4:10 HPMW

Six months after my belly bloat episode, on the eve of Marcy’s 53rd birthday and the second anniversary of her admittance to Cancer World, I joined her and three of her closest friends for a concert by N.E.D.  “N.E.D. is cancer talk,” Marcy explained in her email invitation. “It’s what we all want to hear after a CT scan – that that we are No Evidence of Disease.” By definition, Stage IV cancer is considered incurable, so the women in Marcy’s cancer network strive instead to “dance with N.E.D”.

Made up of six full-time women’s cancer doctors from around the country, N.E.D.’s slogan is, “Breast cancer has a ribbon – but gynecological cancer has a rock band!” The theater buzzed with snappy women dressed for a party. The band started playing – original hard rock ballads belted out by the lone female doc, a hyper-athletic cross between Natalie Merchant and Janis Joplin – songs of love and heartbreak for the ovarian and uterine cancer patients whose disease inspires a rock band but very little funding for research.

They brandished their guitars and drums and microphones and filled our ears with the beat of the human drama – the full catastrophe as Zorba the Greek called it. Marcy and her three younger pals hit the dance floor and threw themselves into it, giddy, gossiping, mugging for photos. I couldn’t quite go there. My mind was busy worrying, calculating how I could get Marcy a doctor like one of those up there on the stage, a rock star doctor who would feel as passionately about saving her as I did. And my heart was stuck on the story she and a support-group friend had told us before the concert started. A year before when N.E.D. had come through town, the youngest member of their ovarian cancer group had shown up and danced her ass off. She’d been on her feet the whole show, having the time of her life. And then she’d gone home and died – that same night.

Anything can happen at any time. Watching all my risk factors – submitting to the twice-yearly exams and all the scans and probes, keeping my body strong, and eating as healthfully as I can – provides absolutely no guarantee that I won’t get cancer or any other illness. Maybe a serious illness isn’t even in my cards. I could get struck by a car and killed as I ride my bike to Marcy’s house.

I reside in what Shapin calls “the risk-factor world [which] holds out hope for avoiding cancer while recruiting masses of us into the anxious state of the ‘precancerous.’” The insurance companies know that’s my address, too. Because I’ve done all the diagnostic tests recommended to me, my only option for individual coverage, pre-Obamacare, was through the state high-risk pool.

My friend Marcy is dying. I’m dying too. We all are. She knows what’s going to be on her death certificate. I don’t. The lumps in my breasts, the moles, the fibroids, the solitary pulmonary nodule – they’re all benign, every one of them.  So far.

During the episode of mysterious high fever and miserable cramping and the escalation of doctors’ concerns, I wasn’t afraid that I was going to die. I’m too good of a rational risk-calculator for that.

My fears reside at a deeper level. Am I big enough, small enough, brave enough, smart enough to proceed with open heart and open eyes through a world that gives Marcy cancer and me just a small dose of necrotic tissue? What sense can I make of a world that gives and takes away so randomly, that offers such exquisite beauty and love and joy and deals out such indiscriminate suffering? Can I make peace with a world that offers certainty, ultimately, about only one thing: my death, and the death of everyone I love?

Questions, I know, no MD or MRI can resolve.

Letting Go

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Have you been swept up in the recent brouhahas debating how dying people should close out their lives – loudly versus quietly? Two doomed women have triggered voluble discussion in their separate determinations to live longer. They share being younger and skilled in amplifying their voice. Being loud has been a part of their strategy. They enjoyed full lives before and during their years with terminal cancer. One has since died, the other struggles mightily in a hospital.

The discussion has not been amongst the dying but rather largely amongst those still living lives of good health. Frankly, columnists needing to find a topic launched much of this with plain poor manners.

Andrea Sloan, typical of many advanced ovarian cancer patients, had no more FDA approved drugs to contain her cancer when her doctor indicated she was a molecular match for a new drug still in clinical trail. She couldn’t access the clinical trial so she organized a team, Andi’s Army, to petition the drug company via public outcry to grant ‘compassionate use’ of the drug. It was denied and she died within four months of her campaign start.

Lisa Sloan campaign for access to drugs

Lisa Sloan campaigning for access to drugs

Lisa Adams suggests no policy changes I know of, she just tweets and blogs her experiences as a lab rat for her cancer, saying yes to whatever seems plausible to keep her alive longer with her young family. She has quite a following indicating appeal.

Lisa (left) in the hospital with her doc

Lisa (left) in the hospital with her doc

I am also rather loud in my living with cancer just as I was rather loud in my pre-cancer life. Whether astrologically flawed as an Aries or for some other reason, I share my reality and am persistent in my medical options. It is not wrong or right.

I watch another cancer sister move into the end zone with her disease. She is as contained as ever. She suffers quite a bit and understands there is no turning around where her cancer is heading. She is actively dying despite still being in treatment. Why, I wonder, have none of my local sisters chosen Death with Dignity, legal in Oregon. But I wonder to better inform my own choices not in judgment. When in my own dying process, let alone how, will I finally let go? Physical pain can be more tolerable than saying that final goodbye, I suspect. I think the terminally ill have few judgments about how to die, we are busy enough keeping our heads above water. Watch us or not but don’t judge.

There is a story about the Buddha being approached for counsel on the best way to handle news of one’s own approaching death. Buddha, apparently, began to flail around in deep, loud, uncomfortable hysteria for several long minutes. Observers had no idea what was happening. Just as suddenly Buddha sat back up, done with the outburst, and said, “There is no right way to die.”

I awoke this morning to an hour of Martin Luther King, Jr’s voice. His speeches are always humbling and inspiring. The hour closed with his final speech before being assassinated. In it he referred to being stabbed in the chest and the knife missing his aorta by the merest of slivers. Doctor’s noted, and the press repeated, that if he had sneezed prior to surgery the knife would have shifted enough to kill him. A little girl wrote in his favorite letter, “I am glad you didn’t sneeze.” May we all avoid a fatal sneeze today and feel gratitude for the choices we are allowed.

A Leader

A Leader

Here Doggy, Doggy…

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Dogs, and the companionship they offer, have been a big part of my life. As a child I calculated for years before talking my parents into a family dog. The humane society was where I found my pups during my adult years. First Sahm, then Boscoe then Tony. I wrote them into job contracts and rental agreements so that the dogs went where I went, they were part of the Marcy package. When diagnosed with terminal cancer, my long time dog pal of 16 years was on his last legs. He was increasingly deaf and blind and the drama of that year was hard for his deteriorating systems. He hung on and on but died the summer after my diagnosis. I was dogless.

My husband, taking seriously the needs of caretaking me, seeks anything that makes our lives simpler. He liked having no dog. The next summer a lovely cat with enormous personality moved into our backyard. We co-existed well. The cat clearly was feeding herself and content so we just enjoyed the daily visits. When the cold weather set in we finally bought cat food, kitty litter and allowed the cat to continue her co-housing. Mike was thrilled to say, “See, you have an animal.” I responded with, “Yes, a cat.” We both loved the cat and the cat did her best to act the part of a dog, following me from room to room, inside or out, and being a companion. But she was not a dog.

a cat, not a dog

a cat, not a dog

As I began the arduous treks to Philadelphia for treatment this past Spring, entering the Hail Mary Pass of an immunology clinical trial, I felt hopeful and a bit entitled. Surely for all this effort I was earning a chance to reclaim parts of my life. Maybe I couldn’t go back to our home in the woods or working fulltime plus or having long hair but wasn’t this effort worthy of some chit? Wasn’t I now eligible to have a dog in my life? My husband only groaned in response to the rhetorical question. So I plotted in my head leaving occasional breadcrumbs about dog rescues for my husband to acclimate to.

In October, I allowed myself to start looking at photos of dogs needing homes and found an incredibly developed subculture of foster homes and transit routes that brought dogs from high kill shelters in California to Oregon for adoption. Foster homes take in these dogs as the frontline placements to detangle their hair, heal their bodies and secure wounded personas, working miracles within the first week but not without a few reduced sleep nights and much cleaning up of toileting errors. I was privileged to meet a few of these moms as I explored adoption. I stay impressed!

Sawyer was on a larger list of cute possibilities that I wanted to check out. He was actually a bit lower on the list as he looked too much like my last dog but I was learning that the all volunteer infrastructure of this dog rescue world meant that there were a lot of unanswered inquiries and false leads. Sawyer’s foster mom got back to me right away and made checking him out so easy. Plus, she provided guidance, wasn’t scared of my health status and agreed to assist in the transition by taking Sawyer back in during my first travels post adoption. It was perfect. And then there was the fact that Sawyer was pretty darn cute. And so I have a dog in my life again, complicating it hourly (no, that’s my shoe; sure, let’s take another walk; sorry, now we sleep) in a way that reassures me I am going to live while I am alive.

Sawyer warming my feet

Sawyer warming my feet

The Flight of Val

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My friends,

V-Tuley-at-Salvation-Tree She is gone.

I got this simple post a day late. Weary from an all day cross-country plane trip, I now waited for the train that would take me towards my lodging. I was alone in every sense standing on this empty platform. My Smartphone informed me that Val was dead. My breath caught.

There was no surprise in the news. I had visited Val in hospice the night prior. Val lay there emaciated, glowing, moving in and out of lucidity. Cancer had won the struggle for the body. Diagnosed at 39, surrendering at 44, Val, in the words of her obituary, “relished life.” In the same obituary it noted, “In her hands a cancer diagnosis became a creative medium for conjuring an astonishing rich garden of community.”

I was lucky enough to be a small part of that community.

Val had stable cancer when I met her three years ago, two years into what she once called “This Great Difficult Thing” but she was still getting her ‘magic juice’ every three weeks with an eagerness I found encouraging. Here she was, made to order. I had put the word out that I wanted to meet a stage iv woman younger than me. I needed to be shown that this journey was doable. Val was a good one for inspiring. When I learned she biked everywhere and was recently seen splitting wood, I requested a date with her.

We spent hours strolling the gardens of Crystal Springs. In retrospect, we both lied a lot, saying how, “this was ok, this knowing that we would die younger than planned.” Despite the big lies we shared the smaller truths of how to find comfort with our terror, how to break down the enormity of our diagnosis, how to cherish the invigoration of knowing that mortality was now more than a concept.

She started her own journey by reminding us that, “None of us are getting out of this alive.” Indeed.

We met a month into my own diagnosis. I still had my long hair on that walk. Val and I were different people – she butch to my femme, she poetic while I sought solace in linear thinking, she musical and I without rhythm. And yet we were consigned to the same path, different entry and exit points, but a specialized highway for those with terminal cancer.

We didn’t maintain a high volume of contact. She was enjoying probation while I was entering lockdown. We had different needs. But Val was always there for me.

Our groups, her Salon of the Scathed and my It’s A Dying Shame, became complimentary platforms for exploring the taboo topics encountered when walking towards death or having death walk towards you – it’s never really clear with cancer. Humor, irreverence and rawness were core to our shared style. We were determined to experience the range of emotions and to enjoy the process.

Val wowed me with her soul too large to be tethered in one body on one planet. I don’t know where we go next. I am not in a rush to find out. I like to imagine Val as her own little prince on her own little planet still enjoying sunsets and sunrises – one more image of Val to delight.

Val wrote once, “I want there to be a good story to tell. How I will do battle and overcome. How you can all relax and not be afraid to click on this blog. And in truth, even if the thing does grow there are many more steps to take. There are more options. More story.” The story is now in our hands.

An ode to Val by Marcy – May 2013

Welcome to Livingly Dying

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Welcome to a space dedicated to the process of livingly dying – staring at imminent mortality and yet residing in the world of the living. More and more of us are finding the words terminally ill and chronic illness co-mingle. We are living longer and better despite a dire diagnosis/prognosis. But the path is not easy.

We bounce between denial, deep despair, and sheer optimism. All the while, many of us face treatment regimes that whittle us down and a current culture in the United States unfamiliar with sitting with death and dying. These writings will be of most value for:
a. people navigating the balance of living when told you are dying
b. people pursuing creative approaches, especially those stimulating our immune systems to fight back the diseases trampling us
c. people interested in witnessing one person living each day with terminal illness.
Livingly Dying Essays, Clinical Trial & Creative Approaches,  and Medical Industrial Complex Woes make up the three categories on the lower right column of the front page allowing you easy access to content that most interests you. To receive new posts click the follow button in the upper right column. I share my journey to support collective efforts to live well while dying. I am feeling my way out loud. Thank you for joining me. Comments are always welcome, in fact, they cheer on the process. If you scroll below this welcome, you will find the running narrative with most current post on top.

For those who like seeing and hearing more than reading, click for the YouTube film of me explaining the concept of Livingly Dying https://www.youtube.com/watch?v=365W0sJq8BE 

Alive! Three years into the cancer journey

Alive! Four + years into the terminally living journey.

Marcy Westerling – marcy@rop.org

The Philly Chronicles – a start

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My ovarian cancer recurrence in October of 2011 condemned me to the predictable but somber reality of life in treatment. My care team and I selected the Penn trial as the hail mary pass best suited for me surviving longer in this reality. Frankly, there wasn’t an extensive menu of choices. Many other women reached the same conclusion creating a line of hopefuls since winnowed down by the ravages of this disease and hefty qualifications. This week, 19 months after starting the process, I signed the entry paperwork with very little fanfare.

The final countdown to entry allowed me the first moments to switch from ‘must get in’ mode to ‘holy shit, what the fuck am I doing’ mode. It hasn’t made the trial any less compelling, just made my ability to survive the rigors of cross-country medical care a concern. Anyone who knows me knows that I am the ultimate homebody. Additionally, I crave open windows and being outside. Airplanes, airports and hospitals are the worst form of punishment.

Now I consign my high holy months of summer and fall to endless air travel interrupted with endless hours in the hospital. Palliative care patients are counseled to select quality of life since quantity will elude us. The quality/quantity tradeoff is complicated by hope – might I get a bit more time by sacrificing my quality? A more amusing tradeoff is the irony of my lifelong politics prioritizing local solutions (before it was cool) and now I select the least local medical care possible.

I completed my second trek to Philly this week. In the eleventh hour I cancelled months of detailed planning that had me scheduled to stay east between the two May appointments. I got seriously ill at the end of April, which humbled my pretensions of strength – I bought a new roundtrip ticket with bad seats and high prices, as I needed to come home.

My relationship with the travel gods has always been tenuous. It’s like they pull out their most mechanically flawed planes when I show up. They fix them, which is nice, but not before hours are added to the journey. The Houston leg of my late night trek home included several hours circling the city to burn up enough fuel to allow a safe landing and plane change. I crawled into bed at 5:30 am Philly time – a long day by any standards and my standards are not normal.

A month in and I am learning my Philly landscape – who gives reliable answers, what will happen each visit, how to navigate the city and where I sleep.  It’s a pleasant city that I have walked enough to feel oriented. My volunteer host is well situated and generous. More importantly she has windows that open! A tiny terrace!!! I can walk the two miles to my treatments!!! These details mean a lot.

For much of my treatment I have opted to go solo. Getting medical care is my new job and people go to their jobs unaccompanied. Furthermore, I hope to extend this into a marathon versus a sprint and that means rationing how I complicate other people’s lives. But I am now realizing there is a big difference between going solo a few miles from your home with a rolodex of allies willing to be on call as needed. In Philly, I am a true solo act. There is no back up plan. Yet.

Mike can’t stand not going with me but I remind him of the importance of some stability and normality in our lives. He serves as the safe harbor I throw my mind to as I miss my life. I visualize him living for the both of us. He is the person who tends my every need when I am home but we still have enough balance that he stays my lover not just my caregiver. He attends all decision-making appointments but that’s it. I draw lines. They help me cope. But I missed him horribly this last trek.

Luckily, Philly is a fun city just $8 by bolt bus from NYC and other settings. I hope to explore having an east coast care team that can break up the monotony and challenges of this trial so far from home. (Any takers out there?)

The apheresis is next on May 22nd. It’s the dreaded procedure where 10 liters’ of my blood will be removed then returned minus dendritic cells. It’s hard on any body and mine was fragile before I started three years of treatment. My sister-in-law is driving down from upstate NY to share her competence and cheer. I leave for the hospital at 6 am, with all my gear (100% roll-able because I cant carry anything afterwards.) My plane departs at 8 pm that night returning me home at the alleged hour of 4:30 am Philly time. A long day. But then the hardest part is done (hopefully to be re-done only one more time in September.)

The first week of June I return to Philly to start actual treatment – chemo one day, vaccines the next then observation then HOME for 3 weeks! I will learn how to master this trial, the travel and ways to keep this a journey I chose – one that need not just challenge my quality of life as I barter for more time.

I close by sharing the invaluable words of Susan Gubar a colleague in living with incurable ovarian cancer. She blogs about her journey at the NYTimes capturing so many of the complicated emotions and body issues that I face right now as she talks about her life in a clinical trial. I say, ‘ditto.’

much love, marcy

MAY 9, 2013

Living With Cancer: Good News Soup

By SUSAN GUBAR

People with incurable cancer do sometimes receive good news, as I have. Why is it harder for me to share good news than bad news? During treatment, good news produces elating highs, but also anxious lows.

When I entered a clinical trial for a new cancer drug, the consent form stated that the medication would not provide a cure and could kill me. The pills’ effects on my ovarian cancer were to be measured by the CA-125 blood test, in which numbers above 35 indicate disease growth.

I started the trial last August with a CA-125 over 100. As the number fell in the autumn to 38, in the winter to 9, and in the spring to 5, my morale rose – tempered by occasional dips and drops.

My family and friends are ecstatic. So is my oncologist, who wrote in an e-mail: “You do not even know how exciting it is to see the results of this new drug. I do a lot of clinical studies and I see so many negative results, some of which are fatal. We do all that work to get one rare patient who gets benefit … very rewarding to see it happening to my friend!”

The last two words of this message touched me to the quick. After four years, Dr. Matei had entered my heart and (apparently) I hers. A great joy to make a new friend at my age and in my situation, especially a friend so admired.

Yet I worry that I will fail her. A number that descended in the past nine months can ascend in the next nine months. (Overwhelming odds are it eventually will.) Might sharing good news jinx it — turn it, in the blink of an eye, into bad news?

I know from the nurse administrator of the trial that the experimental drug is not benefiting women with breast cancer. My good news makes me distressed about their bad news. Also, I had overheard conversations in the hospital waiting room about other ovarian cancer patients dropping out because of deleterious side effects, some of which I experience.

Weak from months of dosing, I cannot stand on my feet to cook for more than 10 minutes at a time. At the supermarket, I ogle ready-made meals. Changing the sheets on the bed requires time-outs. Filling the bird feeder, hauling it out, bringing it back in at night (so the squirrels can’t raid it) takes too much fortitude. Bones ache that I did not know I had. My hair has thinned so drastically that Joanne at the salon clipped it close to the scalp, all the while lambasting comb-overs.

Diminishing the cancer seems to involve depleting me. Still, I have kept my resolve steady by focusing on the satisfaction of contributing (if only in a minuscule way) to medical research. I had also kept myself on an even keel by hunkering down for the worst.

Now, with the best possible results, I am a neophyte who does not want to be an ingrate. My trepidation at the lowering cancer marker reminds me of the angst recounted by many patients at the end of a round of successful chemotherapy. The gift of time starts to feel like a present spoiled by uncertainty about the future. With cancer, you can’t win for losing.

Yet today I would rather be a cheerful Tigger than a gloomy Eeyore. So to buoy myself I decide to use the chicken stock defrosting in the fridge, its fat congealed on the top, to make matzo ball soup for my visiting daughter and son-in-law.

After I toss most of the fat, saving a tablespoon, I start whipping up the egg whites. But one of the rotary beaters of the electric mixer refuses to stay in its socket; it keeps falling out, no matter how I swivel it. I am here to testify that the gizmo works with only one beater. That, too, feels revitalizing, even though my low numbers and high spirits may have started to change on the day you read these words.

Tonight there will be homemade soup. Tomorrow I’ll put out the bird feeder and leave it out, despite the squirrels.

http://well.blogs.nytimes.com/2013/05/09/living-with-cancer-good-news-soup/

 

Expiration Date: an essay on Livingly Dying

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Technically, this last year was a tough year but, in fact, a year ago I was six months into failing chemo after chemo to handle my first recurrence. My options were not looking great as I penned an essay Expiration Date that I cut and paste below. (Please feel welcome to share.)

Diagnosed with cancer after a collapsed lung, my statistical odds were a 10% chance of living beyond two years.
This past year we fought for and got surgery to remove my largest tumors, found a chemo regime that worked and we keep fingers crossed that my cancer will stay stable until I sign paperwork for entry into the clinical trial May 8th. Today I enter my fourth year with this cancer. Most of the time I am in treatment and always awaiting new blood work to reveal which direction the cancer is moving. There are few opportunities to feel confident.

Not every day is a great day but almost every day has great moments. Just like for many of you, I suspect.
They say tomorrow kicks off a string of sunny days – what more could I want. Well, stable blood test results would be very, very nice as well.  xoxo

Expiration Date: an essay on Livingly Dying

I was once known for buying deals on almost-expired meat. However, I didn’t limit myself to expired meat but that behavior earned me top notoriety in my friendship circle. Taking expiration dates too seriously was never my thing. Expired cold meds even seemed to offer an occasional high – who knew?!

These days I am grateful for my common sense attitude toward dates as I stare down the ultimate expiration date – my own. One month into my 51st year I was given a 10% chance of being alive in two years.

People say funny things as they attempt to comfort the terminally ill while managing their own fears.  One common statement reassures that, “We are all terminally ill.  You just know it”. “Harrumph,” I think. I do know. I more than know it as my weary veins dodge yet another dose of toxic poison infused with the knowledge that it will bring me to my knees with exhaustion, nausea, brain fog. Slight consolation is the hope it will keep me alive awhile longer.

When first diagnosed on April 22, 2010 the doctors made every effort to be factual but tactical.  Incurable and metastasized were mentioned, but not terminal, not palliative care. Yet every appointment from then on seemed to include the statement, “You will die from this disease.” It was like a boot camp mantra – getting me used to my new normal. I was in shock but I could still rebel at that edict. “How dare they,” I fumed. But then one day I realized the only way to avoid dying of this disease was to have some other tragedy end my life. What kind of victory would that be? Would my oncology team really be impressed that I managed to get run over just to avoid suffocation by cancer?  I finally accepted I would not die of old age, but from ovarian cancer. 

I have learned a lot about advanced ovarian cancer. It is recurrent, relentless and fast to adapt to any chemotherapy sent its way. Ovarian cancer is not a particularly painful cancer. I like to note, “my people die looking good.” We tend to move in and out of treatment, giving us some much valued recovery time, which is further boosted by steroids when in treatment. It seems wrong to call our form of cancer a wasting disease. One day the doctor will simply inform me the cancer has outwitted all the chemo types available, and treatment will end. I will then enter hospice and die soon thereafter – looking pretty much like I always have albeit possibly bald and ten pounds heavier courtesy of those steroids. I claim the ovarian cancer sisterhood as my people now, because they teach me how to live and die by example. It is a tough group of women constantly being whittled down with funerals and then expanded as the newly diagnosed walk in.

I stand on a particular type of death row. I have been sentenced, but some vague appeal process offers me the possibility of being an outlier – one of the few who survive for over a decade despite the dire odds. No one knows why. Unlike an actual death row inmate who is confined in every aspect of living, I have freedom of movement, tethered mainly by treatment timelines, financial realities and other choices. What I am denied is the freedom to assume I will be alive three months hence. What started as an insurmountable burden I am learning to accommodate. I move from solitary confinement, to a shared cell and then to a mere ankle bracelet with frequent calls from my parole officer.  It is inconvenient but not intolerable.

For me, I cannot live without hope. When I think of my death as truly imminent I feel a grief that I now see as pointless – I just don’t have the time for such sadness. I choose to save those tears for when I am told it is time to contact hospice and then I will move into that final phase of acceptance.  My current mandate is to live with the shadow of death seated comfortably on one shoulder – I rarely forget but I often dismiss my new companion. Parameters are drawn.

Prioritizing hope does not require me to feel optimistic. I am especially clear eyed right now as I endure my first recurrence too soon for it to be a positive indicator. Worse yet, my cancer has only grown after eight months of renewed treatment on multiple chemos. (Please note: one year later, April of 2013, I am closing out a new chemo regimen that seems to have moved me towards remission as well as entry into a cutting edge clinical trial.)

I have made a certain peace with leaving this world, a comfort experienced only after considering what I might do, where I might be, what I might become after I die. What’s the harm in daydreaming my possible death future? The worst that can happen is that I am wrong. I live in a culture that offers few possibilities around what dying means to the person who has died – it is either viewed as THE END (with many finding spiritual solace in turning into humus for the ages), or viewed in mythic versions of heaven and hell. Neither option works for me.  

Weeks after my diagnosis I sat in the Spring sunshine by a burbling creek at our homestead. My sweetie was doing the chores that I was barred from doing post surgery.  This was a favorite resting spot of mine. The chickens made their comforting sounds in their enclosure to my right while the more rambunctious ducks blurted out their loud, harsh and comical sounds in the pasture to the left.  The garden emerged behind me. I was surrounded by so much that I loved. The warmth of the sun reached every nook of my body. The tears I cried were happy ones. Why could this not be my heaven? Why couldn’t I decide that here I would reside, barred from engagement with my former world, but observing it more happily than not? I make the choice to imagine my next world much as Peter Pan declared, “To die will be an awfully big adventure,” even if he imagines his death more boisterously than I do mine.

I have heard of stoic, terminally ill people who chose not to burden others with their diagnosis. I have yet to meet these people. Others allegedly fear being defined by their illness. My response to the diagnosis of terminal cancer was to count down until the first remission allowed me to get a large tattoo on my wrist declaring me a Cancer Warrior with the script positioned for any newcomer to read. Every bag I carry sports a button stating, “Cancer Sucks”. I dare the world to ignore my diagnosis just as I defy any attempt to limit me to my diagnosis. I bike everywhere, slowly to accommodate the damaged body, wishing for a banner across my back to allow those swiftly passing me to know that I am biking despite cancer in my chest, abdomen and pelvis. What a small way to proclaim what it means to live fully with your expiration date. How comforting it might be to the newly diagnosed to have such models. 

Two years in and my closest friends increasingly challenge what they see as my negative self-talk.  I am in palliative care. I have been in palliative care from the beginning. I missed the few curves that could have portended improved outcomes – longer survivability. All success is measured by longer survivability, especially by me. I recurred too fast. The cancer is now ten nodules versus a few which would be possible to grab via surgery. Yes, I think palliative. I hate it but I would hate more missing this closing phase of life by pretending things were different. 

Deep inside I continue to work on a story line that allows me to live – I fall asleep to the effort, I awake to the possibility.  I pray for a miracle knowing that, really, only a miracle can save me now.   The deepest part of me still believes I will survive despite my intellectual clarity that advanced ovarian cancer is almost always terminal. I just can’t imagine saying goodbye so young. And then I fret; maybe I did talk myself into recurring so fast.

I get my affairs in order. I avoid paperwork at this phase of life and focus instead on my closure — painting rocks for memorial service party favors to be remembered by, quilting for loved ones, making time for conversations I would rather not have. I have written up a burial plan.

I live on death row in a lovely neighborhood, in a lovely house surrounded by perks that don’t eliminate the sadness of departure.  I hold my pink slip from this world. My life stays filled with joy and meaning as well as a mantle of sadness – the former only enriched by the latter. Years prior I wondered, as do many, would I rather die unexpectedly – poof, be gone? I suspect not. I like to orchestrate. I definitely intend to script this phase of life and be thankful for the opportunity.

Some days resentments push forward. I know how much fun retirement would have been with all my friends. Will I really have to miss the magnificence of the maturing front yard that I’m planting this Spring? Will someone else match my devotion to what I leave behind of my life?

My expiration date has passed. I live. Today is another day on death row. I embrace livingly dying, in the words of the late Christopher Hitchens, and I am grateful for this luck.  

Marcy Westerling – Oregon

written Spring of 2012

It’s a Dying Shame – an essay

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Please Note: This essay is adapted from a journal post entitled Messy Snapshots – Reader Beware.

It’s a Dying Shame  A shout out to the less honored side of facing death – when more public grace and stoicism are shoved aside and the darker emotions take hold. What do we hide, and why? What do we lose?  What do I lose if I hide?

I heard a story about the Buddha being approached for counsel on the best way to handle news of one’s own approaching death. Buddha, apparently, began to flail around in deep, loud, uncomfortable hysteria for several long minutes. Observers had no idea what was happening. Just as suddenly Buddha sat back up, done with the outburst, and said, “There is no right way to die.”

This story gives me solace.

People love to say to the terminally ill, “You are so stoic, so graceful. I could never handle this so well.”  Perhaps not, but the greater truth is you may have no idea how well or badly we, the dying, do handle it.

People I am in casual contact with believe I comport myself well. Even though I lack the energy for hysteria or the time for despair, I certainly feel both.  When in treatment with chemotherapy I have the solidity of bodily discomfort to remind me there is an effort underway to keep me alive, and it might just work – in other words, I have HOPE. And with hope my daily life can be oh-so-fine.

When I am not in treatment but need treatment, I sink, hour-by-hour, deeper into a very dark well. It’s the well I found myself in when diagnosed two-and-a-half years ago with metastasized cancer. There were times when I could see some glimpse of sky. But when the sky was obscured, the basic activity of breathing took all my energy.

A message arriving from the larger world – a photo, a mundane tidbit, cookies – allows me to find some sky, whether for thirty seconds or an entire day. That is the power of a tether to the world I fear leaving. That is the power of small acts of reaching out – not fearing to say the right thing, but instead opting to say something.

Since August 2011, when the rising numbers of my blood tests could only indicate recurrence, I have had episodes of complete darkness. The tests and the waiting that surrounds them wrings me out like a shirt hand rinsed more times than its weave can handle. I get my numbers monthly, interspersed with October, January, April and then August cat scans – all of which show my cancer on the move despite switching treatment approaches several times. I am running out of options. The weave on that beleaguered shirt seems unable to withstand another wash. You retire such a beloved shirt. But being retired from treatments only leads me to hospice. These are high-stake test results. My mother urges me to relax. She is old and can’t bear to watch another of her children die. She means well, but relax? — how cruel an intimation. Most philosophers see the ultimate struggle of life as contending with death. I know I will be relaxed, as are most diseased people when death arrives. I am not sure, though, I can stay both human and relaxed while awaiting these announcements of death’s relative positioning – the tests are my only way to check in on its approximate arrival.

Some patients get good news and celebrate. That’s my hope. But I have been traveling an uncharted road, with breath held while waiting for such news. Now fifteen months of lousy test results leave me worn out.

At such loaded moments I need support from contained people who follow my lead – who understand that one minute I might seek updates about weather and children, the next instant I switch to exchanges about my death, my memorial, my hopes, my fears, then back to the best new show on television.

Following each appearance of further bad news, always worse then I anticipated (despite my pre-cancer self always assuming the worst!) is a break in my treatment plan. These are dark, dark periods where there is no sign of any sky. I think of childhood shows like Flipper and Lassie and wonder, “How can they ever rescue me when I am so hidden?” I know Lassie can find me when I see sky, but here in this totally dark zone it must be asking too much. My fate feels sealed. I am doomed. The end is imminent. And I am not ready. There is no courageous acceptance here.

From the start of my cancer journey, I have been held in amazing community. Meals coordinated via a Helping Hands website. A team of friends research best clinical trials. A few others seem to track every infusion date, magically checking-in, knowing that infusions are rarely routine. They are ready to drop their busy schedules to accompany me to an appointment. It is assumed that my sweetie can only do so much.

This community is more than a circle of love. It is a scientific advantage in staying alive. Study after study shows that those patients who are fully engaged in support circles as well as in their health care decisions, survive longer and better.

When the darkest moments hit, I am least able to reach out, and thus links to my support system fail. Out-of-state vacations and busy work schedules steal away those who have been so solidly on the front lines. My stalwart friends, working as a team might be maxed out with bureaucratic efforts to save me. It’s a much needed to-do list, but not a scaffold down to my dark, hidden cave somewhere that I can barely identify. I try to crawl out when my beloved returns, oh-so-tired from another workday moving stones and earth. But they are not the stones and earth that hold me entrapped.

He never complains as I excerpt highlights from my day underground. I share a cute, endearing vignette to prove that really, I can handle all of this; it is safe for him to leave for another day of work. But I know he knows the layers of my pain and carries what he can off with him. Perhaps he truly is moving some of the weight that I feel obscuring me as he wheelbarrows his way through another day.

Does much of this sound stoic, courageous or full of grace? It should not. It is not. It is dirty, sad, barely witnessed pain. And so I ask you, dear reader, be less generous with your accolades. Be suspicious of my silences and smiles. Learn that protracted death asks more from you then being impressed. Dare to look behind the curtain. Dare to assume that I am not stoic, courageous or full of grace between treatment plans.

Allowing more dimensions to emerge makes walking towards death seem more doable. When we keep our conversations polite and are afraid to put down our upbeat masks, it distances, simplifies and cleans up a terrifying stage of life. It forces denial. I cannot think of any moments in life better suited for full honesty than birth and death. The primal pain of birth refuses to mask a dirty process. Death allows more options.

Recently I convened a group of terminally ill women in my living room under the name It’s a Dying Shame. The recruitment invitations mixed humor with frank language and created a little stir. Medical privacy laws make it hard for patients to find other patients so we recruited providers to spread the word. One supportive provider wondered aloud why I would use the phrase ‘terminally ill’. Really? Why?

I have been bludgeoned with that phrase since diagnosis. Maybe I lie. Maybe it is more accurate to say that no one has used that phrase and instead they repeat ‘you will die of this disease’ over and over. Excuse me if I translate what that means. This provider went on to say, “People want to live with hope.” Again I felt sucker punched and could only reply, “But I live with enormous hope. I am determined to live another twenty years. In one hand I hold the scientific reality that my odds of surviving another few years are dismal. In the other hand sit my just as clear-eyed hopes.”

When the room full of women gathered, the shared motivation was to talk our truth. None of us had such space despite all of us having attended other more formal support groups. None of us wanted to be labeled terminally ill but all of us were, even if etiquette requires more gentle language. The current rules of polite company make the journey towards death more isolating. As one woman noted, “It is like we are standing in a different room.” Our truth, though, was expressed with humor, not tears. I hadn’t laughed this much all month.

We are asked to hide the emotional side, even when humorous, to protect a culture that is not skilled at facing death. We lose the chance to become a culture that sits with death, sadly but comfortably, just as we accept that for every baby born, a new dead body is promised. A dead, cooling body need not be scary when we are given such awareness. Instead, we are offered zombies.

My first nightmare happened as a six-year-old after watching an episode of Get Smart, a weekly comedy of a goofy secret service agent. I loved the show but in this episode there was an overwhelmingly crowded room full of mannequins where the agent got trapped. They were over, under and around him at all angles. I was not too young to catch some whiff of the mannequins as metaphors for death. My discomfort with the agent’s situation extended into dreams and entrenched my long-term fear of bodies.

At my grandmother’s open-casket wake I provided hysterics when coached to kiss the body. When my 18-year-old brother died in a car accident, I accompanied my mother to identify the body. He was wheeled in behind a viewing window. Hours later we visited him in the funeral home. I removed the horrifying toe tag wired to him. He was nude. I so hated the minimal sheet assigned to offer warmth, and the thought of him being left alone that night was unbearable. I have disconnected snapshot memories of being at the crematorium and hearing the loud whoosh as his still nude body was fed to the flames. I fled. I was on a plane home before his body was reduced to fragments of bone. I doubt any cultural realities could have made such a tragic death more bearable. Tragic will always be tragic. But would I be less haunted if I could have spent the night with him, washed and dressed him as I imagine he would have chosen, and experienced more than his cold, violated, vulnerable body on slab after slab? I yearned to hold this body I had embraced so much in life.

Recently I had a front row seat in how fitting it is to sit with the body of a dead person. My brother-in-law was diagnosed with ALS nine months before it killed him. We are a small family on all sides. Smaller still by geography. This second terminal diagnosis so quick on the heels of mine seemed rudely timed. But disease is not about respect. His fast entry into hospice and faster yet progression towards death surprised us all.

Few folks made it in time for his final breath but his poet wife narrated it with beautiful detail allowing us all to feel as if we were almost there. We arrived within the hour. The living room was crowded, quiet, yet content. He lay peacefully in his bedroom. Candles were everywhere, as was extra seating; this was an enticing place to be. There were no rules for how long you sat, how often you walked the few dozen paces from the living room to the bedroom, what rituals we each selected to meet our own needs. It was so calm, so cushioned. Further visitors were diverted and gradually the group winnowed down to those most impacted. A day of dying made so organic with so few flaws in the scripting. The twenty-year-old daughter was supported in making the few decisions of the day. How and when should the body leave the house? Death had not been invited but was accepted, anticipated and lived fully.

Fred was not particularly brave about his death. Dementia had obfuscated the diagnosis and whittled down his smart intellect. Social niceties were deeply dulled by inroads of the disease in his brain. He startled all of us those first few months by blurting out “I am scared”, received by a deep silence as we tried to manage our response. How wonderful for me to have someone saying the obvious.

He was courageous, graceful and stoic in life and death, but he was also very real. We are all scared. Voicing our fears may or may not make us less scared but surely it makes the experience more bite sized and human. It opens up the door for actual support. I believe Fred’s fear shrunk just a bit each time he stated it.

Perhaps what I most hate about the predictable adjectives assigned to the dying is how they belittle who I was before being diagnosed with terminal cancer. Having been a shy child, I was determined to be a courageous adult. I was.  Fierce, brave, bold – those are the adjectives I worked so hard to own. I am proud that my life has exemplified those words to many. I am brave for how I have lived my life. I am not brave because of the poor luck that finds me with terminal cancer at age fifty.

Our society oddly conflates poor luck with bravery. Think September 11th. Rescuers were brave. Those randomly stuck in the upper floors of the twin towers, had very, very bad luck. They may also have been quite brave but being there didn’t make that true. Bravery should imply some choice. I am not sure I would have made the courageous choice to be a fireman walking up those stairs.

Members of the terminally ill club to which I belong  — those that acknowledge their status — are a pretty raucous bunch. We laugh a lot. We are irreverent. It is a sad but genuine humor, this humor of the brave who cope by refusing to be silenced with politeness.

My momentary good news is that Lassie is dragging me towards air, towards a bit of sky that marks a new treatment plan. With the return of the physical challenges of active treatment I re-find my hope. Perhaps I can use this three-month treatment cycle to better plan for enduring future bad test results. The cycle is predictable. I will find myself back in suspended animation in my cave where there is so little oxygen to sustain me. I need a better plan because during this current stretch I have barely been able to endure my own psychological stench. But this is what prolonged dying looks like when the messy moments are not hidden from view or glossed over. To camouflage such realities is an injustice to understanding human life, mine included. What would the Buddha say to that?

Marcy Westerling – Oregon

September 2012

Dancing and Thinking Out Loud

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Monday, July 30th , for better or worse, I will be profiled live in the second half of Oregon Public Broadcasting’s Think Out Loud.  If you go here http://www.opb.org/thinkoutloud/shows/marcy-westerling/ you can even pose a question – ones that bring it back to rural organizing are valued.

Marcy Westerling

AIR DATE: Monday, July 30th 2012

POSTED BY: JULIE SABATIER

At 53, Marcy Westerling is taking stock of her life and legacy as a community organizer. She’s also making tokens for her friends to remember her by. Two and a half years ago, Westerling was diagnosed with terminal ovarian cancer. She says,

“I can accept dying and dying young. What I’m less OK with is disappearing…I want to be a mentor for younger organizers and allow myself the gift of feeling like I’m going to be carried forward even though I don’t have control over how long I’m here.”

Westerling is probably best known for founding the Rural Organizing Project (ROP) in the 1990s. ROP is an advocacy group focused on sexual and racial minority communities in rural Oregon. She’s stepped back from her leadership work at ROP, but she remains very involved as a both a mentor and keeper of the group’s institutional memory.

Do you have experience with the Rural Organizing Project? What would you like to ask Marcy Westerling?

While the OPB show might be fun, what will be much more fun is a dance party slated for Saturday, August 18th.  The best DJ is donating his time and great food and beverages are being lined up.

A Summer Dance Party! Save the date – share the invite

To benefit the Rural Organizing Project & all our psyches

Hosted by Marcy Westerling* & Cara Shufelt

Put on your dancin’ shoes because ROPers and urban friends are gonna dance the night away in Cara’s backyard!  (With great food and drinks and music.)

When: Saturday, August 18th 6-9pm

Where: Cara’s Backyard:

What: An evening party to mix & mingle, hang with ROPers & Marcy, dance the night away to a live DJ and support the work of ROP!  Great tunes and good times.

* special note:  I will be getting my inside look scan results the week prior – these determine if this chemo is working after a long year of limited success in containing my cancer.  So, you can well imagine that dancing, if the results are good (please!) or bad (wah!), will be very, very therapeutic.

Not What I Wanted…New Scan Results

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Well, it’s my 3rd ct scan in a row with lousy news.  I have new cancer growth after 5 months of chemo.  19 chemo doses and the cancer is growing.  It’s enough to give a girl doubts.

So, I will get another port installed asap with great hopes that the surgery works this time because the veins are done.
And then I will start on the imported doxil that I should have gone on 6 months ago were it available.
My bone marrow is very tired but my body continues to function fairly well.  I biked the hour each way to get my dour news.
And my great ‘research’ team abandoned their personal plans for last night to huddle instead over strategies to get my prior clinical trial unblinded and leave me eligible for a new clinical trial out of Pennsylvania.
And that’s enough to give a girl the sliver of hope she needs to keep on keepin’ on.
Enjoy the now because it is real.
xo  marcy
p.s.  The photo attempts to show a work I made at a death and dying workshop last summer.  You may or may not be able to tell that the turtle is literally 1/8th off the work and leaving the lovely nature scene.  I was trying to create the sense of moving forwards, regardless, to inspire me when it all seems a bit much. (Of course, the turtle and I both know that she is headed to an even better beach.)

Two Years and Counting

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Greetings all.  The month between my birthday (March 25th) and Earth Day aka my little brother’s birthday (April 22nd) in 2010 marks the roller-coaster month of being diagnosed.  A month where I went from a 10 mile/day bike commuter to a woman who couldn’t gasp enough air to climb the stairs to her bedroom.  And thus a collapsed lung was diagnosed and weeks later stage iv cancer.  In that month I lost so much that was. Today I biked the hour each way to my 19th dose of chemo.  Next week I have my three month look/see inside.  The last two such check-ins were full of sad news.  I hope this one is as close to dull as possible.  Regardless, life is good.

Below I share a piece I wrote last month after attending a memorial for a younger friend diagnosed 6 months prior to me.
David’s Sendoff

I did not fret the plane’s departure. There were no papers to hang on to, no bags to lug, no crowds to survive. It was just time to go. And then there I was admiring the world above the cloud laden skies of Oregon – a rising red line marked the emerging sun, small eruptions like stepping stones for giants made me smile as I knew the clouds obscured massive mountain bases below. This journey would be just fine regardless of where it took me.

Yesterday at this time I was getting ready for the memorial of a friend. He died at 42 leaving behind a beloved wife and two young children. Cancer ransacked him. Cancer has me as well, metastasized since diagnosis and yet relatively well behaved compared to the sieges David endured in his 2 years. I prepare to close out my second year with cancer, dependent on chemo cocktails and regular cycles of ill days to stay alive, never knowing when the cancer will surge and end the tentative truce I pretend to have with it. I do know that soon I will surpass the prognosis of a 90% chance of being dead within two years. I am not smug. I get the creativity, control and chaos of my dance partner. But I am content.

Where is David now? He never mentioned death as an option as the rest of us counted down the days to his body’s complete retirement. By the end they were pouring chemo directly into his brain. It was always clear to me, his terminal sister on this journey, that his body was being asked to endure too much.

I dreaded the memorial because I had been so sick the days leading up to it due to an allergic response to my latest dose of chemo. I needed a walking stick. I could not afford to leak a tear, as my body was already so dehydrated. Armored with my gals as chaperones, whether to fight off death or any other assault on my system, we arrived in good cheer and stayed there as we got to know David, the husband of our colleague Grace, far better than we had in life.

The church was at capacity with formally attired folks, somber but grounded in the presence of so many children too young to cope with adult displays of grief. Hushed tones and sniffles took the place of keening. The grieving widow seemed more a bride – gorgeous, smiling, cuddling children in their world of play. Lighting funeral candles was fun when enveloped by relatives and attention. “Where is daddy?”, is a question they had asked far too much in the prior two years – the youngest was not yet three. They did not seem to wonder today.

It ended in the best of ways. I understood better why David was so special, why Grace built a life with him, why the crowd was so full and why he and I could be pals in the next world. I am trying to accumulate fun contacts on the other side.

For now my plane flies above the clouds. The sun reveals that another new day without David is fully in process. Everything I see is peaceful and I wonder why it is that I have been taught to fear death.

much love, marcy

Back in Chemo-land

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Christopher Hitchens died a few days back from his cancer and while I was mainly neutral on his work, I did develop an affinity for him as we both underwent our dramatic diagnosises with advanced cancer in the Spring of 2010.  He chronicled the strange journey so well that I could relax in my own attempts to describe it.  His initial Vanity Fair column on his cancer became one I referred many a friend to, then and now, for being so spot on.

He describes the original process of calling in emergency help, “…but now that I view the scene in retrospect I see it as a very gentle and firm deportation, taking me from the country of the well across the stark frontier that marks off the land of malady.”

“The new land is quite welcoming in its way. …the humor is a touch feeble and repetitive, there seems to be almost no talk of sex, and the cuisine is the worst of any destination I have ever visited. The country has a language of its own—a lingua franca that manages to be both dull and difficult and that contains names like ondansetron, for anti-nausea medication…

He wryly notes, “In whatever kind of a “race” life may be, I have very abruptly become a finalist. To the dumb question “Why me?” the cosmos barely bothers to return the reply: Why not?”

And then with these closing paragraphs he captures the odd bargains, suffering and causes an advanced cancer patient faces when they know how the story ends and yet vie bizarrely for more time.  “The oncology bargain is that, in return for at least the chance of a few more useful years, you agree to submit to chemotherapy and then, if you are lucky with that, to radiation or even surgery. So here’s the wager: you stick around for a bit, but in return we are going to need some things from you. These things may include your taste buds, your ability to concentrate, your ability to digest, and the hair on your head. This certainly appears to be a reasonable trade. Unfortunately, it also involves confronting one of the most appealing clichés in our language. You’ve heard it all right. People don’t have cancer: they are reported to be battling cancer. No well-wisher omits the combative image: You can beat this. It’s even in obituaries for cancer losers, as if one might reasonably say of someone that they died after a long and brave struggle with mortality. You don’t hear it about long-term sufferers from heart disease or kidney failure.

Myself, I love the imagery of struggle. I sometimes wish I were suffering in a good cause, or risking my life for the good of others, instead of just being a gravely endangered patient. Allow me to inform you, though, that when you sit in a room with a set of other finalists, and kindly people bring a huge transparent bag of poison and plug it into your arm, and you either read or don’t read a book while the venom sack gradually empties itself into your system, the image of the ardent soldier or revolutionary is the very last one that will occur to you. You feel swamped with passivity and impotence: dissolving in powerlessness like a sugar lump in water.”

So Christopher Hitchens publicly ‘lost the battle’ on December 15th 2011, a battle more accurately lost on the day of his diagnosis.

It’s been a long silence from me on the caring bridge site.  And not one of those good silences but one where I have tried to decide what is my mood as I face ‘livingly dyingly’ (again in Hitchens’ words) with suspended despair.  I don’t want to waste my time with sadness but dang, recurring so fast and with the first choice drugs not available, it is hard not to feel a steady drum beat off in the shadows.

But I do apologize for being so lame at getting out an update.  Many days I try but before I can decide what to say I have lost my limited energy.  I could say ‘I am fine’ because basically I am fine for a stage iv ovarian cancer patient in her first recurrence.  I could confess how hard this reentry into chemo land has been; bore you with my medical woes that have seemed endless this round.  But I don’t want to dwell in my pain for a moment longer than I have to.  Soon I have a good day or hour and I am caught up in appreciating those moments.  “How am I?” is a volatile question that I rarely know the answer to.

I have loved these short, dark days of late Fall.  As the solstice approaches to mark the return of light I have mixed feelings.  A marker I have so long relished I now wonder if I am up to.  But I suspect I will be.  This week, a week of relative good health because my chemo was delayed yet again due to low blood counts, I actually started pulling out some projects, making lists, test driving my brain and finding some traction.  With the help of so many of you, I remember to put one foot in front of the other and find that I can get somewhere and that’s not bad.

Mike and I did manage to visit my relatives in Holland prior to starting chemo – a lovely sendoff.  Our other jaunt was to a cancer retreat that reminded me yet again that the patient and primary caregiver face equally huge burdens, so, as always, a huge shout out to my beloved Mike.

lots of love and happy holidays, marcy

Partying in the Face of Mortality

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Thank you to everyone who made last Saturday night so special! I would say more but I am still too wiped out. (It will be nice when the post chemo fatigue fades.) Anyway, a long time ROP supporter and friend wrote up his reflections on the day and night – I share his words in lieu of my own. If only he had stayed for the great dj’d dance party at the end…since his narrative didn’t get that far, let me just say, it was great!

“If I were designing a dream event for activists as a holiday gift, it would have looked a lot like the ROP Roots and Wings Celebration. The afternoon brought us the gift of four incredible allies of ROP from across the United States (Tarso Ramos of Political Research Associates based in Boston, Eric Ward of the Center for New Community based in Chicago, Scot Nakagawa from Mexico and Suzanne Pharr from Tennessee) sharing their more than a century of experience in organizing and upholding the values of democracy and human dignity with us. The format of two speakers followed by reflection at each table and then questions turned it into an active process and one that deepened the connections of the people at their tables. As one board member put it the only better thing would have been spending a day with each of the speakers. Like a chocolate cake that’s too rich to eat at one sitting. And then, of course, Marcy (at her Marcy-like best) drawing out the lessons from the speakers and the analysis into a set of questions, a plan, something concrete to take back to the spiritual barricades to guide our work. That would have been a great day… but we were just getting started.

The evening program to honor the roots (including Marcy Taproot) and wings of ROP’s gave us an even deeper place of reflection and connection. Okay, it has been known to happen that when you get together to do a celebration/fundraiser thing people say nice things about each other, pump up the crowd sort of, raise a little money and then you go home. This is not what happened. Honoring Marcy, of course, made it special. And celebrating her continued presence among us raised it to a higher level. Her courageous (sorry Marcy) struggle against cancer on behalf of life, including her own, simply reminds us of the preciousness of what we are fighting and loving for. It matters. It’s precious. So this made the evening special, but it was more than that. The people who have built ROP over the last 18 years love each other. Staff, board members, community activists. ROP has given us the chance to do that by bringing us together to take on struggles small and large… together. Through the campaigns, the caucuses, the phone calls and the visits ROP has done something that social media can’t. It has created a family. And that was what made this evening special. It was family coming together after a day of work to look back on what we’ve accomplished (against long odds) and what we’ve become and forward to where we are going next. Everyone who spoke, spoke from the heart, not from notes on a napkin. Like the Velveteen Rabbit, after all these years and taking a few hits, we’re real. We can talk to each other from the heart, as if it mattered.

And all this against the backdrop of love and deep appreciation. And we noticed that over the last few years we’ve grown as an organization, that we’re able to support each other in ever greater ways. That the new leadership is brilliant, powerful and committed, just as the old leadership was. We’re in it for the long haul. Good things don’t get lost, they build up, like rain in the clouds over a parched desert.

So, if I were designing an event for activists, here in the winter of our discontent, to strengthen us for our work, it would have looked a lot like this.”

With love,

Jerry Atkin

Transitioning to a New Life

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Transitioning to a New Life

This week closes out my first three months of living with metastasized cancer. Stage IV Ovarian Cancer to be exact. As someone commented, “a bump in the road’ to which my sweetie responded “yes, a major bump in the road.” But he laughed as he said it. We stay still saddened by our new realities but also feeling like “We are and will be okay.”

So here is a little snapshot of our moment.

I am glad to be leaving the poorly scripted emergency phase of shock and awe. Frankly, I can’t look back and begin to figure how we could have coped without the swift intervention of so many caring souls. Mike and I bumbled through those first few weeks as grief stricken automatons. There is just nothing reasonable about having everything we carefully constructed and adore about our lives being torn to shreds. Add to that the trigger word of “cancer” combined with “advanced” and our ability to grasp reality disappeared.

Month one we were in full shock. Month two we realized it was time to get with the game. And, by the close of this month we are feeling about 60% present. July 20th marked the close of our emergency trimsester.

Mike and I are doing well. Being protected by family and friends allows us the space to catch up. We do not like our reality but we are ready to deal with it as the loving team that has carved out a homestead in the woods and pushed for new frontiers in justice organizing. We will deal with it as the same loving team. Now we calibrate options for homesteading and organizing with one new reality, getting me into a very long term remission (length of time in 1st remission correlates with length of life.) There is no recipe for staying in remission. We recognize our limitations and the serious stakes we face. But we also feel hopeful.

Medical staff at Kaiser actually used the word ‘great’ in a sentence describing how I was doing – a first from the world of dour oncology. And my tumor marker continues a jolly downward trend not only indicating it is a useful tool to assess how I am responding to chemo but also that I am on a clear trend towards remission.

One bittersweet recognition is that my permanent health status might require me to be in thick of resources vs the woods. Leaving the woods, the pond, the year round garden and our many sources of homestead joy is a tough and still not completed decision. But we are looking for a new home in the city.

The next step in our stabilization phase is returning to living on our own.

Journey With Cancer – The First Hello

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Journey With Cancer – The First Hello
Written 45 days after diagnosis (June 2010) and my first formal communication to friends and supporters. Adapted for broader readership in 2012.

April 20th, 2010 at 6 pm, I park on the side of an Oregon highway waiting for a return call from a doctor. It is gray. I learn that I have “advanced cancer” in a brief call. 36 hours later that diagnosis is refined to Stage IV Ovarian Cancer. There is no Stage V.

In the diagnostic roller coaster leading up to this call I have bartered endlessly, assuring myself of how accepting I could be of any diagnosis but cancer. Congestive heart failure, sure. Rheumatoid arthritis, easy. A fungal infection with a 25% risk of death, absolutely. I share my bargaining chits during various emergency consults where anonymous healers attempt to figure out why the lung of a healthy fit woman has collapsed. My negotiations fail to amuse a single doctor.

April 22, 2010: it is Earth Day and two days after that initial call. It’s also day three of the oil gusher in the Gulf; it’s the day my dearly departed little brother would have turned 43; and it is the day I am handed my formal death sentence. Any show of control collapses. I have drawn the shortest straw in my diagnostic bundle. My life as I had constructed it comes to a close. Crash, boom! Any illusion of free will has been replaced by the will to live.

It is 45 days later now. I have been coming to terms with my short straw. I see my job as using acceptance to construct a new life, however brief. In recent weeks I try on many faces including wise, gracious, funny and sad but I am never as genuinely sad as when I walk out of my Ovarian Cancer Support Group meetings. It is then I feel in the deepest pit of my stomach the very imminent reality of my death. God damn.

Feeling my death is so raw, unlike anything I have felt before. Thinking about my death stays a mere exercise of intellect – it is a removed and obvious truth that I can surely handle. Feeling death is so incredibly sloppy. Slow tears trickle out as I move towards a very different type of acceptance and grief. There is nothing for me to give permission to in this experience. Death is coming for me and it could be coming fast. In allowing myself to feel the reality of death, my stomach lurches endlessly, radiating out in cold, sharp spasms. It is as though I’m enduring a constant replay of the dream-fall when sleeping – the one where the stomach lurches and you are shocked awake at just the point you realize you will hit bottom. But this is real and there is no dream to awaken from. This is a Stage IV Ovarian Cancer diagnosis when you have suspended thinking and grasped Truth.

I am re-born in this free fall. I am re-born to the council of my medical team – “You must start living as if the next three months are your last. And when you are still alive at the close, make a new three month plan.” This is living with Stage IV Ovarian Cancer. It is a sneaky diagnosis that will allow me to look and feel great as the cancer makes its own decisions on longevity. It will decide which three months are my last. We will all find out together as the final three months dawn.

I believe I can do this. I will learn to live in three-month intervals. I will hope and dream and build in smaller allocations of time. But am I going to do this in my heart or in my head? In my head it is a mere storyline I can make interesting, wise and abstract. In my heart it is a constant tremor radiating from my stomach as I fall to my death several times a day or maybe several times an hour. I am offered drugs to derail the anxiety as I fall, but what do I lose if I take the edge off? And, if I don’t take the edge off, how will I get anything done or feel any joy or feel anything other than desperation?

45 days in to my new reality and I am bald. My signature long blond hair is gone. Catching a glance in a mirror is jarring, demoralizing. Why this overt humiliation now?

My house is also sick. It has been diagnosed with mold and so I am barred from entering because mold could kill me – an irony I try not to dwell on. My living quarters are reduced to a single room generously loaned by dear friends as they shower me with love, laughter and attention. My middle class American life has been whittled down to what will fit in a few bins. The bins taunt me with lessons of detachment. Must everything now be about preparing me to leave this world?

I have started to vanish. I can sense colleagues and friends, overwhelmed with the demands of their own lives, cutting me out of the day-to-day flow of work-based communication, so as “not to derail me from healing”. I crave updates about everything that formerly was my life. It’s been a mere 45 days and my erasure from the news of the day is underway. Does no one else see the irony of not distracting me from getting well? So many ironies at Stage IV.

There is so much more to acknowledge, like the bundles of love sent my way through cards, notes in the virtual guestbook, food and good reading material. As I free fall, kindness envelops me and cushions such a scary moment with light and possibilities. As we all struggle to find our best place in this very real drama please don’t fear making mistakes. Cancer is a mistake. Reaching out to me will never be a mistake.

I am lonely and scared. I am like a little Who from Horton Hears a Who — hanging on a thistle screaming out, “I am here, I am here, I am here.” Please hear me, love me and help me live this last phase of life as completely as possible. Just don’t rush my disappearance. Please.

Marcy Westerling
Oregon • June 10, 2010

I’m a kickass community organizer dedicated to the notion that small town Americana is filled with justice seeking souls that deserve support as well as have the power to bridge the false cultural divides of our times.
– Marcy Westerling