Saturday was the third anniversary of my Whipple surgery, that 12-plus-hours-long procedure available to about 20 percent pancreatic cancer patients. The procedure involves the removal of part of the pancreas, the entire gall bladder, the duodenum, a portion of the stomach along with a few other bits and pieces.
The five-year survival rate after the Whipple is 20 to 25 percent. Given that the five-year survival rate for all pancreatic cancer patients is under 10 percent, I have been living on golden time.
(I've sometimes wondered why the medical community chose five years for measuring survival rates. Three years with such a dire disease seems pretty good to me.)
The odd thing is that I don't recall noticing the date on the first and second anniversaries. Surely I must have made note of them but who knows. I've discovered during this journey that my mind sometimes has a mind of its own.
On the day I was given my diagnosis, I had no trouble deciding I would not pursue what are politely called “alternative cancer treatments” but should be labeled quackery. (See this report on a 2019 Yale Cancer Center study of alternative cancer treatments.)
My reasoning then was (and still is) that the doctors and nurses who have been treating cancer for years know a whole lot more than I do about what works and what doesn't and that if there were a miracle cure, we would all know about it.
So I put myself in hands of the medical people, followed their instructions carefully and here I am these three years later.
What is far less straightforward and for which there are no doctors and nurses to help, is the question of how to live with a deadly disease day in and day out for whatever time is granted. Shouldn't something change?
For nearly six months after the Whipple I was in recovery mode with energy and physical capabilities severely limited. Without putting a whole lot of thought to it during that time, I continued to write this blog - sitting at a computer doesn't impinge much on one's body – as I gradually regained my strength.
The doctors and particularly the nurses were good at explaining chemotherapy side effects when that treatment was started and except for two or three days after an infusion, life was close to what it had been before cancer (and in 2019, COPD) intruded.
It was then that I began thinking more earnestly about whether I was spending my time in the best possible way. Generally, I've settled for continuing to do the simple things I've attended to each day since I was first made aware of the cancer.
Still, death seems to be such a monumental event that it should require a proportional response. I'm not saying that's true, just that it feels that way sometimes and the intrusion of that thought interrupts the comfort of my routine.
Neurosurgeon Paul Kalanithi came close to saying what I think I am experiencing – or, beginning to experience - in the last entry of the journal he wrote which was published after his 2016 death as When Breath Becomes Air:
”Everyone succumbs to finitude,” he wrote. “I suspect I am not the only one who reaches this pluperfect state. Most ambitions are either achieved or abandoned; either way, they belong to the past.
“The future, instead of the ladder toward goals in life, flattens out into a perpetual present. Money, status, all the vanities the preacher of Ecclesiastes described hold so little interest: a chasing after wind, indeed.”
Since I'm still asking the question now and then, I haven't reached the state of being-here-now that Kalanithi describes. But I think he's right and I also think that if I'd just leave myself alone, I'm heading in that direction and doing just fine.