Another birth Day

When set against the gift of life he gave me it’s a small complaint, but my surgeon forgot to mention I’d end up with two belly buttons. Today on my birthday I lift my shirt and look again in the bathroom mirror at my new stomach, replete with its six wounds, the most obvious the big one that dimples right above my old bellybutton. It was here where the robot, guided by the surgeon, Dr. Anidjar, pulled my prostate in a little cloth sack out of my body, and with it, I hope, all of the cancer. A re-birth of sorts, its evidence a hole from the mechanical umbilical cord.

I am unimaginably fortunate. Dr. Anidjar called me at home to tell me the news. The biopsy on the removed gland had come back from the lab. Rather than the localized tumours that the MRIs and the initial biopsies indicated, final tests showed there had been cancer on both sides. But when the medical staff tested the margins of the prostate, they showed no cancer. The surgeon’s conclusion: the cancer was spreading, but it never breached the gland. They got it. In that moment he sounded happier than, oddly enough, I felt. As I stammered out some kind of response he said ‘Don’t thank me. Thank Doug.’

“Doug” is my urologist. He is also, coincidentally, my ex-father-in-law, normally the last person – other than your actual ex – you want poking about your private parts. Yet he was the one to urge me, despite my reluctance, to have a second biopsy. The day I stood in his office digesting the bad news of my results Doug (Dr. Morehouse) stood up, came around from his desk and hugged me. As we awkwardly embraced I experienced so many competing discomforts there was no way to keep them straight: the realization that for a surgeon to hug you after a cancer report is probably a very bad thing, remembering happier hugs in happier times at their family cottage, trying to absorb the fact that he had just used the word “survivability”, or wondering how my ex father-in-law meant it when he told me that if I wasn’t going to be smart enough for my own sake to have surgery, I should for the sake of his grand-daughter.

To Dr. Anidjar on the phone, I said: “I’m thankful to you both.”

The reason I am unimaginably fortunate is only my lack of imagination when it came to cancer. This is not normally a problem for me, but a certain numbness set in two years ago and never really went away. I hadn’t imagined – or allowed myself to imagine – that the cancer had, as they say, “gotten free”. Free for what? So far, at every major step of this process, I’ve assumed the best possible outcome. And so far, at every major step, I’ve been wrong. When my PSA was high, I just assumed I had an enlarged prostate. True, but there was cancer. Then when I had my second biopsy I dreamed the tumors would have shrunk or disappeared, because of the typical lassitude of prostate cancer, and from my change of diet and positive attitude. None of those hurt me, but my cancer didn’t care. It had spread anyway. So when I was waiting to hear the oncology report on the removed tissue, the best I could manage was a kind of emptiness. Not visualizing good results. Just not visualizing anything.

Then the news, the “envelope is clear”. When I put down the phone, and before I began the round of phone calls and emails and texts that took the next couple of hours, I was in a state of shock. Was, I say. Still am.

It’s taken me the last two years just to begin coming to terms with having cancer. I’ve finally been able to say the word about myself without either imagining I’m a character in a short story or keeping one eye on the person I’m talking to, to check their reaction and therefore guess at what mine should be. I was far from coming to own the word, but I was beginning to adjust.

Cancer has been, in its own weird way, a liberation. For the first time in my adult life, I felt free to tell people I didn’t want to do certain things, good responsible things, for the sole reason that I didn’t care to. I gave different excuses, but sometimes I was just making them up. Underneath all of them was the feeling that maybe I don’t have much time. I’ve spent money more freely, traveled at every opportunity, let emails slip by and commitments sometimes go unanswered. Cancer allows you to be more honestly selfish. I’ve been frenetic at times, slightly depressed at others. I’ve begun to say, at least to myself: ‘I have more important things to do’. In these last few weeks since the surgery I’ve experienced being helpless, and having to be taken care of, which is not easy, sometimes for the caregivers (ask Cathy, who saw me stricken and waited patiently) sometimes for me. I’ve learned enough bravado now to walk into a drug store and ask for male under-pads and tell the clerk that no, it’s okay, I will walk out without having to hide them. To fancy that I’m like a Shakespearean actor and instead of being shameful, they’re rather like a codpiece. We all handle embarrassment in different ways.

I guess I’m a cancer survivor. I know there are other people who get worse news from their doctors. I don’t know why it is this way for me, now: why my slide into this particular tragedy seems to have stopped here. I don’t trust the news, of course. Part of me fears the disease is just biding its time, waiting to come back if I should forget it and become arrogant about life and longevity. It’s a kind of superstition, I know, and it tempers my thankfulness. But it’s what feels most natural today. So on my birthday I lift my shirt and look in the mirror at my second belly button and think about rebirth. I wonder sometimes if symbolic things happen to me or if I’m just one of those people who tends to see the symbolic in everything that happens.

Good Boy

catheter in garbage

Fair warning: this is a blog post about masculinity, aging, self-perception, fear and catheters. It may get uncomfortable. It has been, and still is, for me.
On the day of my one week post-op appointment, when finally I found my way to the radiology clinic there was an elderly woman blocking me. She was standing in a space that was almost but not quite at the reception desk and almost but not quite in the hall. As people squeezed by – ‘C wing, no, you have to access that by the first floor, you can take the blue elevators but not the ones there, you have to go up one floor, straight ahead, then to the left’ – she was turning her head, very slowly, from one direction to the other, a branch caught in a fast-flowing stream. I sympathized. I couldn’t move that quickly myself. “Ma’am? Do you need help?” a nurses’ aid stopped. Another woman slowed, kind eyes on the woman as if she wanted to help, but didn’t know what to do. People started backing up behind us. “I need the…. the…what’s it called again?” the elderly woman said.
Behind the counter, the clerk, standing, had one hand on her hip. She kept looking up, then down at something in front of her, and then up again: “Ma’am, this is the radiology clinic.” Then, more loudly: “Radiology.” Some of the dozens of people slumped in chairs were watching, but most seemed lost in their own thoughts. There are lots of bright and cheery spaces in the Jewish General. Not radiology.
The nurses’ aid reached out and tried to take the elderly woman’s elbow, but after a step or two she shook it off. For a moment then they just remained in place, looking at each other: “Ma’am,” said the nurses’ aid, not unkindly but quite loudly, as if the woman’s problem was deafness instead of confusion. “This is a hospital. Why are you in the hospital? Can you tell me?”
“Sir?” A line of sight had opened. The clerk had forgotten the woman and was looking at me. “You have an appointment?”
I suspect I was a disappointment to the radiology staff. As I lay on my back for the x-rays that would check my plumbing an overly tentative resident, a senior radiologist who swooped in at the last minute and a nurse who actually seemed to be the only one who really knew what was going on poured dyed fluid into a cup connected to a clear plastic tube connected to my bladder. Then the three of them held the funnel high in the air, looking to me for all the world like auto mechanics jointly topping up my oil. Except that I could really feel it when my reservoir was too full. It was the ‘having to go to the washroom so bad you won’t make it’ desperate kind of urgency that, although catheterized in any case and forcing my stomach and legs to stillness, made my feet kick back and forth against the hospital metal. “Tell your surgeon we didn’t get much into you,” said the radiologist, leaving. I could only see his back, “and will somebody get some towels in here?”
When that trial was over I was limping through the labyrinth again, to the surgeon’s office. Despite the fact that lots of people in this world, and I know, lots of people, have had catheters removed, nobody warned me. It certainly was one of the most bracingly gasping few seconds I’ve ever undergone. As the deflated bulb is being pulled down the urethra and out of the body (you thought I was going to say penis, and it would be true, but I’m saving that word), there is a sensation that beggars description. It starts with pain but doesn’t end there.
Being unstapled was easy by comparison. My various abdominal wounds were liberated of foreign metal quickly and without bother, the steel bits clinking as they were dropped into some unseen metal garbage. Perhaps it was that ease that made me overconfident, thinking nothing much more was about to happen.
I shouldn’t complain. If I thought removing a catheter was bad, at least I wasn’t awake when they put it in. And I’m hardly unique. Men in nursing homes routinely have catheters changed. For me, the sharp but quick pain marked a major step back to normal. Or at least, mostly normal.
I hope.
One of my very earliest memories is of a euphemism for urinating properly: it was “good boy”. It must have arisen during the first months of being diaper-free. ‘Did you do good boy?’ my mother would ask my younger brother and me (I suppose I’m conflating these dim memories with photos when I imagine her in a bee-hive hairdo, although it was the 1960s). Maybe she thought the word “pee” was too rough, and “urinate” too technical for our toddler tongues. Maybe it was what we, learning language, naturally enough called a successful visit to the washroom, repeating a mother’s words back to her. I don’t know. However it happened, calling the control of where you point your penis ‘good boy’ probably says a lot about where a male is headed in life.
I remembered that expression when the surgeon sent me home with the words “your only real job for today is to rest and to make sure your bladder is working. Your big job for today is to pee.”
It’s not so much that I’m afraid of being a bad boy. It’s that I’m afraid of losing what it means to be a man. In the dimness of the radiology clinic, thinking about the elderly woman, I realized that I was in some subtle way telling myself that I wasn’t like all these other people. I’m younger. I’m healthier. I’m more aware, more thoughtful, more driven. It was a lie, of course, otherwise why was I there? And the purpose of the lie was to spare myself from fear, the usual post-operative fear that, with a catheter being taken out and a prostate removed, a urethra reconstructed and most – but not all – of my nerves spared, maybe I will never be fully myself again. Whatever exactly “myself” means, a half-century after first being told I was a good boy.

Prostate Cancer

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After about a half-hour of conversation with my visitor I get tired and notice I’m thinking about my bed. Not that I’d go to sleep exactly; just lie down awhile and let my mind go blank. “Oh don’t worry,” says the nurse, who calls me later. “That’s normal. Goes with having surgery and general anaesthetic. Your body has gone through a trauma. Every day you’ll get stronger.”
She’s right. I am.
The nurse was helpful, but all quick questions and firm reassurances. This wasn’t the conversation for relating how fascinating I found it that the state-of-the-art Da Vinci surgical robot with which Dr. Anidjar peeled away my prostate almost a week ago uses two joysticks and multiple foot pedals. It’s a little detail, but so reminiscent to me of the earth-moving equipment I worked alongside as a young student on my summer jobs. Back then I was struck by the delicacy of some of my otherwise rough fellow workers as they scraped earth away from an underground pipe, or smoothed a patch of healing concrete. There was something incongruous in how a mechanical arm could look so forbidding and yet reach out so tenderly.
I never got the chance to see the tenderness that moved the Montreal Jewish General Hospital’s much more refined and technical arms – six alien appendages – last Monday. I never witnessed the very skilled, kind and attentive Dr Anidjar work his art (and I believe it is an art). I would have liked to.
Karl Jasper talks about something called ‘limit situations’, times when you become aware of the very finite boundaries to your own power. Cancer is one of those times. According to my friend and colleague Christine Jamieson, Jasper’s point is that powerlessness creates a boundary situation, a moment when if you’re attuned to it, you can become aware of transcendence.
“For now,” says the nurse on the other end of the phone, “rest easy. Your job is to heal.” I’d like to tell her about the summer evening at age 19, when after a few drinks, I boasted to the back-hoe operator I could do his job, and we took a bet on my trying it. I’d tell her how we drove out to the field where I proceeded to shudder and slam the shovel into wounded earth until finally the operator in disgust made me give up and lose my money before causing real damage.
Experience and artistry: I am glad that the Jewish General surgeons had both. Limits and transcendence: I have experienced both this week, and there is more to write on that.

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Dreaming of Pilgrims

escapees
It’s wonderful to know artists. Some time ago I woke up after a dream in which I had watched a woman in a medieval scriptorum ‘break open’ a Celtic Gospel manuscript and draw medieval figures leaving the manuscript even as modern pilgrims came in to explore. As we were preparing for our Pilgrimage Conference at Concordia (May 3-4) I told two artist friends: Janice Poltrick Donato and Cindy Walker. Janice drew my dream! And I wrote a poem to the escapees. What a fun way to prepare for an academic conference! (Janice and Cindy will be unveiling the full artistic creation and working on it at the conference in reaction to the academic papers – we’re calling the process peregraffiti)

To the escapees from the Lindisfarne manuscript:

When you stepped through the wall it must have surprised you
to see…..
Well, to see nothing at first,
just space,
blank front and behind, if blankness has direction.
Your eyes scratching for purchase,
anything…
here no richly knotted, woven gold, no winding serpents swallowing tails,
no clever labyrinths of animal overlaying cross,
no tight little fecund world,
Just horizon.

It must have been a shock.
After all, most escapes automatically come with dreams:
I don’t know,
rich tapestries lining a foreign street, a feast heavy with laughter,
kisses stolen,
a light-dappled meadow honeyed by bird-calls.
Something, at least.

Poor you. You got nothing.

Or rather, you got space –
line-free, free-lining, free-wheeling space,
the pilgrim’s only promise: space to walk:
stories unfurling like steps
stretching ahead.

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