Is this a fight?

We often talk about fighting diseases. We say, “I’m fighting a cold.” And people talk about “fighting cancer”. They might say, “she won the battle against cancer”, or “he fought bravely, but ultimately lost his fight against cancer.”

Having cancer sometimes feels like I’m in a fight. I try to maintain an even temper, find solace and peace, and not cry out too often. I try to do what I can to be a good patient, take the prescribed medicine, ask the right questions, find out what more can be done, all without being a nuisance. I try to make the right moves in this fight.

But it is not really a fight at all. A “fight” suggests some kind of fairness to being in the ring. Like, I somehow qualified to be there squaring off with Mike Tyson or Manny Pacquiao.

Can a single human being be in a fight with a tornado, a flood, an earthquake? Can you be in a fight against a force of nature? A cold, maybe. We can fight a cold, because everyone gets a cold from time to time, and it goes away.

But this cancer, this stage 4 pancreatic cancer, is not like that. It is a force of a nature, unremitting in its brutality. I am not qualified to be in this fight, nor do I think is anyone else. One cannot beat this thing; one can only live longer.

If there is a fight being fought, it’s the medical community who’s doing it, who’s working on new medicines and clinical trials to see what can be done. I believe these doctors and researchers will eventually, in the next few decades perhaps, find a cure and beat pancreatic cancer. But I will not be here when they do so.

It is funny how it stills feels like a fight sometimes. If I die from this disease, which is likely, it feels like I will have lost. But if I win, it would feel like it was luck alone that let me win. I guess if I were in a fight with Tyson or Pacquiao, it would be much the same.

Drugs I am taking

What drugs I have been taking: Folfirinox (my chemotherapy regimen: Oxaliplatin, Irinotecan, Fluorouracil, Folinic Acid), Emend, Ondansetron, Dexamethasone, Prochlorazine, Creon, Fragmin injections, Nupogen injections, and Citalopram.

What drugs I may start taking: Pot.

My brother likes to repeat joke that I like: You know what they call alternative medicine that’s been proven to work? Medicine.

I’ve heard many suggestions for various alternative medicines, passing along a few to my medical team (doctor, nurse practitioner, nurse, dietician, pharmacist) to see what they would say. Everything I mention, they are sceptical about its value, but at least they think a few are harmless. And so if it’s important to me to try those ones, they tell me to go for it. But it’s not important to me if it doesn’t work. I want to know what works. And I don’t want to spend my time and effort on things that do nothing.

But when I asked about marijuana for symptom management, wondering if it had any value at all or it was just another crazy theory, the doctor said, “yeah, let’s get you a prescription.” The nurse practitioner said, “yeah, we’ll get you a prescription to a dispensary. It can help with nausea, low appetite, and insomnia.” The nurse said, “Yeah, most patients here are on pot. And chemo patients have been using it for decades. Make sure to use vaporizers; they’re much better to use than smoking it the old fashioned way.” There was no question of its usefulness. The team was unanimously in favour of me trying it.

So there you have it. Pot was once an alternative medicine, but it ain’t alternative no more. It’s just medicine now.

Allowing ourselves to be imperfect

I thought the limited time I have left would somehow make me wiser, that it would focus my life like a lens and force me to confront only that which was essential. But that has not yet turned out to be the case. That turned out to be just a metaphor I made up.

I still watch bad TV. I still read about the American election. And I still get angry about things. Here’s a short list of things I’ve been angry about over the last few weeks:

  • The Republicans blocking Obama’s Supreme Court nomination.
  • The rise of Donald Trump
  • The rise of Ted Cruz
  • My mom giving me unsound advice about nutritional supplements and alternative medicines.

Notice that this is not a list of things I should be angry about, or things I would rather to be angry about. I would rather be angry about unnecessary poverty, children dying of malnutrition and curable diseases, continued racism and sexism. (Maybe that last one is captured in my anger about Trump and Cruz, whose words are so abhorrent, I am unwilling to think through exactly what is wrong with them.) And maybe wiser not to be angry at all.

But one thing is clear: what I’ve been angry about ≠ what is sensible to be angry about. And that is old hat.

Having less time to do something ought to mean that you try to spend less time on the trivial. But I’ve been spending more time on the trivial – doing crossword puzzles, reading silly articles in the New York Times, reading reviews of movies I will not likely watch, and worst of all, watching interviews of celebrities on YouTube. And some of my better habits have fallen away: reading and writing philosophy everyday, meditating everyday, exercising three times a week, going to bed at appropriate times, etc.

I guess we have to allow ourselves some imperfection. I am however proud to say that I still floss everyday.

Fantasizing about not dying

I’ve been fantasizing about not dying. I imagine ways in which I’m part of the 4% that live more than five years after a diagnosis like mine (stage 4 pancreatic cancer). I even imagine being part of the 50% who live more than nine months, rather than the 50% who do not.

I imagine hearing my oncologist tell me that the cancer has shrunk enough to be operable. And I imagine the operation and its recovery. I also imagine that the cancer just goes away and that my next CT scan simply cannot find my cancer anywhere. I imagine hearing from a pancreatic cancer researcher that they’ve identified the specific gene mutation for my cancer (whatever that means), and that they, by chance, have medicine specific for it. I imagine the scientists and doctors find a cure for cancer in the next nine months, and this cure is simple and easy enough to be implemented quickly and universally in our healthcare system.

I imagine that I wake up from a terrible nightmare. I imagine that this world is an illusion, that I am a brain in a vat, and when I “die”, I wake up in reality. I even imagine a heaven, where I’m up at the Pearly Gates explaining to God that there wasn’t enough evidence to believe in Him. I imagine being reincarnated as another human being, and that I get to enjoy living once more.

Is this what hope is? Fantasizing about unlikely possibilities? I know clearly that I want to live. I want to live much longer than what the odds tell me. But I don’t expect to. And I cannot plan my life around unlikely possibilities.

What is hope? Is it something between want and expectation? What does your mind do when you hope?