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. 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.


Prostate Cancer


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.