Category Archives: Cancer

There but for Fortune

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I have often been accused of being too literal, and so please understand that when I use the phrase “dumb luck” I have no intention of insulting anyone, but instead I use the phrase because, quite literally, luck itself cannot speak.  It has no message, no meaning.   It doesn’t know where it comes from and it doesn’t know where it’s going.   It’s a meandering ghost lurking behind every tree and under every stone and in every breath we take and even those we don’t.

Pilots like to believe that they are in control of their destiny.   It’s important that they believe that, because if they didn’t, they likely wouldn’t step foot in a cockpit and advance the throttle.   Flying is certainly more dangerous than staying at home and watching TV, and that is because there are more opportunities for something unlucky to happen.   “Fate is the Hunter” could not be a more apt title for aviation writer Earnest Gann’s autobiography, along with a 1964 film starring Glenn Ford and Suzanne Pleshette.   Shakespeare said it best when, no doubt while sitting on a pubstool, he said, “Shit happens.”   Good thing there was a bumper sticker writer around to write it down at the time.

I have found it fascinating over the years to listen to pilots discuss a recent deadly accident—any recent accident.   One might think they would be kinder to fellow pilots, but most often they are angry and critical of the pilot who died.   Even before knowing a detailed explanation, they blame the pilot for doing something stupid to cause their own demise.   “Pilot error” is in fact the cause of over 75% of fatal accidents according to the NTSB, but there’s a big percentage left over.   And that’s where the hunter comes in.

Dumb luck wields its unwitting existential sword in all directions.   It kills and it rescues.  Take, for example, my bout with stage IV cancer.  I don’t exactly feel lucky to have survived this far, now seven years after my cancer diagnosis.   Instead, I attribute my survival primarily to modern science and the physicians who have mastered their art at City of Hope.    I never had much hope, really, nor did I have much faith.    What I did have in copious amounts was resignation and compliance.   And in the end, I think it was entirely them, the physicians, who were to blame for you reading these words.   I am deeply grateful, even if you’re not.

But that too involved not a small measure of luck.   I had a protein, labeled simply P16, residing in my squamous cell carcinoma that was particularly responsive to the chemotherapy and radiation that killed, or at least postponed, the tumor’s metastasis.   That was lucky.    And I was lucky to have found that team of physicians who practiced their art form flawlessly, as well as a profoundly supportive family to monitor and shield me from contextual harm.

And yet, there are those whose bodies end up downstairs, in the basement morgue, refrigerated until claimed by their loving and supportive families.   Many of those had copious measures of hope and many of those even had sublime faith, but the mortality police came and snatched them anyway.  

The thing about dumb luck is that, by definition, it is out of our control.   We can hope and faith our way through the vicissitudes of this churlish life all we want, and the freaking plane might still crash, and the wayward car might run the light and smash us to smithereens.   These are hard realities, and not incidentally, it’s the anticipation of the slings and arrows of outrageous fortune that is the definition of anxiety and the chief reason why pharmaceutical companies remain a good investment.

What remains out of our control can plague and preoccupy us, or we can choose the path of optimism, with the caveat that optimism when blind becomes ignorance, and ignorance causes a lack of the kind of healthy vigilance that keeps us relatively safe.   Going with the flow I sometimes think can be fun in a kayak, but it can also smash the kayak into a boulder and ruin our day.

Optimism, I suppose, is simply the idea that luck strikes disproportionately on the positive side of things, giving more than it takes.   The balance of probability, as Conan Doyle’s Holmes would say, certainly leans in that direction.   Plane crashes happen every day, but proportionately to miles flown, that’s still very little.   When they do, it’s usually the pilot’s fault, but usually isn’t always, and there’s still more than a smidgeon of fate involved.  So, to paraphrase the brilliant folk musician Phil Ochs paraphrasing everyone else, there but for dumb luck go you or I.

Arriving

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I am editing this post now on a short flight from Warsaw to Cracow, where a small disability film festival will be showing the film I produced and I will be doing a Q&A. The captain will soon announce our arrival in Cracow, and despite my trepidation about being in Poland for the first time (the land my ancestors escaped from), I am looking forward to the adventure.   But before I arrive, here are a few thoughts I wrote about the idea of arrival:

I arrived late at my friend Ollie’s house a couple of weeks ago, in the midst of a conversation among some of his “LA friends” about the three legs of the stool that comprised “success.” I don’t recall exactly what those three legs were—I vaguely remember something about opportunity and luck, but I do remember bristling at the idea that—while everyone was arguing about the legs, no one was questioning what “success” meant.   So I tried to guide the discussion there, and it came to me that they were discussing something akin to what I might have preferred to call having “arrived” somewhere, not unlike landing at your intended destination.   Each of us may start our journeys with a different destination in mind, and at some point we realize we have landed, taxied to the safety of a hangar, and tucked our airplane in for a good night’s rest.

Of course, not all journeys are specifically intended, as has been the case of my last few years living in the thick cloud of fear of my cancer returning.   Because it seems that over time that particular fear recedes somewhat, I believe I will find success, or know that I have arrived, when my few and far between moments of serenity become closer together.   I don’t suspect the ultimate serenity will likely come until the ultimate end of the journey, and of course it is possible it won’t come even then.

For some of the others at Ollie’s house, it seemed unclear to me that they had any idea of what having arrived at their destination might look like.   How many movies must you produce before you feel as though you can rest on your laurels?   Must it be just one more than your successful producer father?   How many screenplays must you write and how many Oscars must you win? Will one of those gleaming statues on your mantel do just fine, or will you ache for its identical twin?   Triplets? How much money will reside in insured bank accounts?

There is an old aviation saying that the key to a good landing is a good approach.   In order to do something well, we need to prepare the road in front of it.  Perhaps that is where the three-legged stool comes in to play.   If the first leg were opportunity, that certainly does seem important.   I did not have the opportunity to fly until my kids were grown and I was close to 50 years old.   Opportunity might imply a certain privilege, and a certain amount of discretionary wealth.   It also might imply a friend in high places who will take you there.   Luck also does seem important, although I know there are some who might argue that there is no such thing.   I believe though, along with most people and the bumper sticker, that shit happens, which also implies that from time to time shit doesn’t happen.   That’s luck, and I do think there are some who manage to inadvertently walk into a lynch mob or catch their big toe in a bear trap or find a malignant lump growing somewhere in their body.   Shit happens.

I don’t remember the third leg (and I’m not sure I have the others right either), but I imagine it must have something to do with skill or mastery.   There’s just no way to safely get to the end of any runway without having mastered the skill required to fly the airplane.   There may be shortcuts to opportunity and luck, but I suspect there are no shortcuts to skill, mastery, and the elbow grease required to get there.   At this point I don’t find it particularly difficult to land my airplane, and it is easy to forget the effort it took me to get to that place.  I remember occasionally when I think back, or the time that I made the mistake of giving the reins of my airplane to a fellow pilot who flew his own plane beautifully, and we barely survived his valiant effort to bring my steed anywhere near the center of the runway.   Perhaps a great violinist can play any violin, but I’m not sure what she would do with a cello.   In that sense, perhaps the third leg of the stool is the same thing that is needed to get to Carnegie Hall.

It seems to me that there might be a fourth leg to this stool, which would make arriving somewhere more of a chair, I suppose.   In order to know that one has arrived at one’s destination, it seems necessary to know where one is going, although I’m not so sure about this.   Some people might refer to this as a goal while others might call it an intention.   I have never been a big fan of goals, thinking that it often detracts from the journey itself, but I can’t imagine knowing that we have arrived somewhere without knowing where we intend to go.   T.S. Elliot comes to mind here, of course, in poster form from the sixties: We shall not cease from exploration. And the end of all our exploring will be to arrive where we started and know the place for the first time.

I’m not entirely sure Elliot wrote those words, because I don’t trust posters from the sixties, and I don’t know the context.   But it’s compelling to tie the notion of arrival  directly to departure, in that wonderfully prosaic platitude (and Harry Chapin song) that all of life is a circle.   If we are to consider this notion seriously, as in ashes to ashes, then we will ultimately know that we have arrived when we reach the beginning.   But for now, I’m looking forward to three days in Crakow.

An Anniversary

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Exactly one year ago today I completed my last radiation treatment. As far as I know, no detectable cancerous lesion has returned since then, which makes this a cautious but happy holiday. The caution is prudent, given the size and mass of the original tumor and the fact that it had metastasized to lymph nodes, thus increasing the chances that it will pay a return visit. If it does, according to my medical oncologist, it will do so “with a vengeance” having cleverly re-engineered itself to evade the effects of chemotherapy and radiation.   A relatively prompt death is likely.

I have believed in and witnessed the truth of the saying that “we die the way we live.” Among other things, I have lived a life of short-term pessimism and long-term optimism.   Things will work out in the long run, I have always thought, but the rub is in the present and immediate future.

Unfortunately for me and those committed to living with me, this has made me a rather troubled and troubling companion.   For if the diagnosis of stage 4 cancer does anything, it creates a shift in perception.   Whatever cuddly visions I have had of the long-term future quickly vanish into the thin air of fear.   Some say cancer is a wake-up call, but for me it has always been more than a challenge to wake up at all, let alone from a nightmare  that projects itself into the waking state of monthly hospital checkups, blood tests, radiation-rich carcinogenic body scans, and the harrow of waiting for results.

Yet without the battle there can be no victory, and today is a time for celebration. And in this very moment, as others around me are wont to remind me, things are looking good. And as I try to remind myself, this very moment is the only moment that matters; it is the only moment which this brave and betraying body of mine can ever embrace.

And, perhaps in spite of what you have been kind enough to read so far, I am not a whiner.   I have fully embraced my father’s dictum that life isn’t fair, and that it is all of our jobs to work with what we got.   And though it’s too easy for me to miss what is right in front of me, I’ve got a lot.

It is about 4 in the morning, still unaccustomed to the time shift from L.A. to Galway. Yesterday my wife and I walked over 5 miles along the coast in the gray chilly mist, as the sun set over the Atlantic between this continent and the Aran Islands. Gas-fueled flames in the faux stove heat this cozy AirBnB, a modern addition to a traditional rowhouse just four easy blocks from the pub-lined High street that twists through shops packed with a mix of tourists and locals. And peregrinating through the streets of this, one of my favorite cities, I am constantly reminded that there is nothing quite like the amity, charm and wit of the Irish. In this, the only moment there is, life is good.

So today I will struggle again, as I have each day, to find a suitable folder in which to file the fear that each of these bizarre symptoms that arrive daily, uninvited and unwelcome, are signs of the cancer returning.   No, they are just the creaking of an aging body or the teasing of my guardian angels.   I will, today, try again to inhale the crisp air of gratitude and allow its sweet calming effects to wilt the tension in my muscles.   I will, today, if only briefly, imagine the soft embrace of a mother’s arms in order to protect me from the ill wind, and soothe the bristles of expectation.

 

Flying on my Bicycle in the Blind

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I spent one year of my life living at 24 Randy Road in Framingham, Massachusetts.   It was 1964; I was 10 years old and the world was in the midst of upheaval.   JFK was shot the year before, the Beatles appeared in the U.S., a war was developing in Southeast Asia, “the pill” had taken hold and a revolution in sexual freedom was in swing.   I was painfully shy, and my best friend was the bicycle that came with me from Queens, where I had lived for six years before.

Riding my bicycle was one of the few things in my life that I felt as though I could do confidently, and somehow the sense of being carried along while houses whisked by held a primitive feeling of safety, even serenity.   The sweet thing about living on Randy Road was that it was a hillside (one that shrunk considerably when I visited it with my kids more than 30 years later), which meant that I could get on my bicycle and with some help from gravity could pedal myself into tremendous speed while turning at the base of the hill.

I had repeated this act of cyclobatics so many times that I was confident doing it both with my hands off the handlebars and blindfolded.   I would close my eyes, stretch my arms out to the side, and become a human sail against the wind created by my movement.   One day, as I rounded the corner with my eyes closed, I had the wind knocked out of me as I turned into the trunk of a parked car.   I tumbled over the handlebars as one of them poked me in the chest, and ended up sprawled on the roof of the car and denting it with my very skinny body.   That was the last time I tried that particular trick.

Although my hands were not on the controls, I had at 10 years old what pilots call a “controlled flight into terrain (CFIT).”  Although my eyes were closed, I knew exactly where I was at the time; I just didn’t know what else happened to be occupying the space that I was entering.

CFIT accidents happen for many reasons, but one of the most common reasons is that pilots become overly confident in their abilities.   Confidence in a pilot is a good thing, but just like so many other good things, too much of it can kill you.   The problem with confidence is that it can easily bleed into cockiness, which is the kind of stupidity that leads to decisions like turning your bicycle into a car while blindfolded.

I don’t think that any amount of confidence could have prevented the cancer that came to reside inside my throat.   I have made many decisions in my life that I regret, but none that I could imagine could lead to this outcome.    Truthfully, I am not a big believer in karma;  I have known too many people who do mostly good things in their lives and suffer tremendously, and others who have done horrendous things and live peacefully.   I do believe, along with the great philosopher Martin Buber, that humans are basically good and evil, and the ones among us who live life fully manage to do more of both.

Yet, this cancer does feel as though it is a form of controlled flight into terrain.   Right before the first symptoms appeared I was in excellent health, doing yoga 3 times a week, going on long walks, exercising and eating well.   My life was in a better spiritual place than it had been in years.   Then, there it is, the parked car that wasn’t supposed to be there.

From flying on my bicycle to flying in my beautiful Diamond airplane, I am now on a different flight, a flight in which to a large extent the world of science and physicians are at the controls.  Whether one flies down the street with eyes closed, or carefully plots out the path of radiation to a tumor, the world can be a dangerous place in which to fly.