Wednesday, April 11, 2007

April 11, 2007 - Life Is Short(er)

There's a rather extraordinary interview with Elizabeth Edwards in the April 9th issue of Newsweek. She talks frankly about what it means for her to know that, because of her cancer recurrence, her life will be significantly shorter:

"When I was first diagnosed, I was going to beat this. I was going to be the champion of cancer. And I don't have that feeling now. The cancer will eventually kill me. It's going to win this fight. I come from a family of women who live into their 90s, so it's taken something real from me. There was a time during the day when we were getting test results when I felt more despair than I ever felt in any of the time I had the breast cancer. I have a lot that I intend to do in this life. We're here at the house. I'm going to build paths through these woods so we can take long walks that I intended to take when I was 80. And I have a 6-year-old son. I was going to hold his children someday. Now I'm thinking I have only a slim chance of seeing him graduate high school. How do I accomplish, in what time I've got left, all that I'm meant to do?"

When I was first diagnosed, I went through a lot of that sort of thinking. No sooner did I hear the word, "cancer," than my mind went racing off to the most dire possibilities. I wondered if I'd live out the year. I wondered if I'd ever get to meet the people my kids will marry. I even wondered if it made sense to keep going to the dentist.

Now that I'm in remission, I spend less time in such fatalistic thinking. In my case, it was just borrowing trouble; in Elizabeth's case, with her revised prognosis, it's simply realistic. When people ask how I'm doing, I typically say, "I'm in remission, and we have every reason to expect it will last for a very long time."

But will it? Will the cancer remain at bay, allowing me to live out a normal lifespan? Will I make it to the biblical "threescore years and ten?"...

"The days of our life are seventy years,
or perhaps eighty, if we are strong;
even then their span is only toil and trouble;
they are soon gone, and we fly away."

– Psalm 90:10

It's impossible to say. I'm only 20 years away from that landmark age of 70. Nowadays, with all the centenarians running around (well, maybe not running), even 70 seems way too soon to roll up the awnings. It was different back in biblical times, when life expectancies were shorter. Seventy seemed like a ripe old age, and 80 was serious geezerhood.

Not so, anymore. My mother's going to turn 80 this summer. She just returned home to her retirement place in North Carolina, after an Easter visit with us. She drove her own car all the way up here and back. My grandfather (her father) died a few months shy of 101. He played his last game of tennis on his 80th birthday. When he fell out of a dogwood tree at age 93, breaking his ankle (having climbed a ladder to prune some branches), we kidded him, saying, "Grandpa, you've got to stop climbing trees – it's not like you're 80 anymore!" That sort of longevity was unimaginable, in biblical times.

Do I have the MacKenzie longevity gene? Whether I do or whether I don't is perhaps moot, now that cancer has come into my life. The knowledge of its life-shortening potential, lurking in the shadows of my consciousness, is part of that "toil and trouble" of which the psalmist speaks.

In the film, The Wizard of Oz, the Wicked Witch of the West turns over a large hourglass, and tells Dorothy that when the sands run out, it's curtains for her. I can remember, watching that movie as a young child, feeling terrified by that scene. Some kids were scared of the flying monkeys, but to me there was something far worse. It was that hourglass: the gruesome inevitability of it.

I suppose the filmmakers meant that, once the sands ran out, the witch would return and do Dorothy in. Yet, with the sort of concrete thinking typical of young children, I thought the witch had cast an evil spell over the hourglass itself: as the last grain of sand ran out, Dorothy, too, would slump over, lifeless.

Elizabeth Edwards finds herself contemplating a similar hourglass, these days. I haven't seen that vision yet, myself (despite my early spell of panicky fatalism). I have tremendous admiration for her courageous realism. The sands of her days are slipping away, but her life isn't falling apart, either. She's determined to live as well as she can, for as long as she can.

It's all any of us can do.


Bint Alshamsa said...

I think my situation is a lot more like Elizabeth Edward's than yours, Carl. Edward's is new to this diagnosis so she still has a lot of emotional processing to do. I remember when I was first told that my cancer was incurable and I'd be a maintenance cancer patient instead. I was thinking that I'd never see my daughter graduate from elementary school. Now that she's a sassy little pre-teen, I'm realizing that there's a very good chance that I'm going to have to start thinking about what it's going to be like to have to deal with a daughter in high school or college.

I can recall just ten years ago when my grandfather got diagnosed with a brain tumor, cancer was not as survivable as it is now. However, he just kept living day to day and now he's able to benefit from the vast amount of improvements that have been made during this period. As a result, he's had to go and have a new knee replacement because he's worn out the old one from being so dern active all the time fishing and gardening and boating and doing chores for my grandmere. He got prostate cancer a few years ago and before the entire family found out, he'd already finished treatment and gone back to living his life.

When I first got IMRT (intensity modulated radiation therapy) it was completely unheard of within the tiny world-wide community of chondrosarcoma patients. Now it's considered the best treatment for all those with tumors like mine (and many others types in the same area as well). In a few years, only God knows what's going to be available in the form of cures and treatments for cancer.

It all boils down to this, there's no real way of knowing whether a "maintenance cancer" will shorten one's life span. Just like with those who don't have cancer, we can just keep living our lives with hope and anticipation. As the Bible says in Matthew,

Keep on, then, seeking first the kingdom and his righteousness and all these other things will be added to you. So, never be anxious about the next day, for the next day will have its own anxieties. Sufficient for each day is its own badness.

Carlos ("Carl") said...

Actually, my lymphoma (diffuse mixed large and small cell) is said to have characteristics of both the aggressive (fast-moving but often curable) and the indolent (slow-moving but generally incurable) varieties. So, I don't know what to expect, exactly. Sometimes it sounds like the worst of both worlds.

Yet, you're absolutely right in saying we all just have to wait and see. Most medical prognostications are based on a range of probabilities, anyway (the ol' bell curve). Where we, as individuals, will eventually find ourselves within that range is anybody's guess.

I'm glad to hear about your grandfather's story, and yours as well. Encouraging!

Thanks for the good word.