Thinking Out Loud: Shifting Perspectives Toward the End of Life
Wednesday, 11 December 2019
Perhaps it is the time of year. Or maybe it is my natural bent in life. Or something else. It doesn't really matter why, in the past month or two or so, I have been taking stock of these past two-and-a-half years living with a fatal disease.
Not that I planned to do that. Such thoughts bubbled up from somewhere and now I feel like I've been tagging along for the ride while another part of me examines how I've been dealing with my predicament.
For most of the first six months after diagnosis – June to December 2017 – I was recovering from the massive Whipple Procedure surgery. As the doctor explained then, it takes that long to be fully functional again and I have few memories of those six months beyond resting, healing and learning the daily practicalities of navigating such an unexpected reality.
Almost no one with pancreatic cancer lives longer than a year after diagnosis so even as I regained strength, I began planning for an imminent demise. Looking back from today on that period, I see that I was irising down my life to the basics.
End-of-life documents had been completed before my health issues came to be. I had no bucket list or, at least, no travel I wanted, no big experiences to arrange before I die. I wanted just to live my normal daily life in my home, spend time with friends near and far, ponder the great unknown, and most of all, read books.
That's what I do, what I have always done going back to when I first learned to read: I do it to find out what other people know, what the world is like in its many of its permutations, how others have interpreted life, what great lessons endure and the pleasures of a good story well told.
Overall, I am quite indiscriminate in what I read. Nearly half a century ago, a woman I worked for said to me, “Everything is interesting if you pay attention.” It is one of the truest things I know.
Weekly doses of chemotherapy over three rounds of it during 2018 and early 2019, left me tired to the bone. Concentration on anything was difficult, sometimes impossible for several days after each session but then I was fine. Or so I thought. I see now after six or seven months without those chemicals that I was good way from being mentally functional. I'm much better now.
In early spring of this year, a CT scan showed no cancer. Doctors are careful about how they say that: “no visible cancer.” I remember my surgeon telling me that day, “Go,” he said, “enjoy your life.”
Just a few weeks earlier, I'd had a psilocybin (magic mushroom) session with a guide to deal with my fear of dying. It worked well and to a reasonable degree, remains so.
Since then, the aftermath of that drug and the CT scan may have had something to do with my loosening the restrictions I had imposed on myself in reducing the size of my life.
So I've been watching myself this year. Even while my physical life becomes more difficult due to the COPD, I have been broadening my horizons again, feeling more attached to life than I had been, eager to keep up with a fast-moving world.
Each day I worry more about the political future of the United States while looking in nooks and crannies of the internet for an explanation of the apparently large right-wing rush to authoritarianism, some say fascism.
How can that be? I ask. And no one answers. At least, not satisfactorily.
And then I worry that in addition to terrible outcomes we know such a political movement creates, we will have lost the fast-shrinking window in which we might be able to stave off at least some of the terrifying results of climate change.
What a pickle Earth and the United States are in – and I don't mean that lightly. That heavy, heaving word, “existential,” was invented for such a time as we are living in not to mention, for the age group that mostly reads this blog, end-of-life issues that must be faced in the natural order of the cosmos.
Elderhood is often thought of as a time to take stock, to make peace, to tie up loose ends. Most of us slow down a good deal in these late years, rarely by choice, but it comes with old age, with bodies wearing out. Supposedly, life gets simpler but we, early boomers and late silent generation, got plopped down in one of the most frightening and dangerous periods in modern human history. Oh, goodie for us.
For a large part of this year, as much as a diagnosis like mine isn't ever far from one's mind, I have become more attached to life again.
Back and forth I travel: life, death, life, death. Maybe I am learning something about Viktor Frankl's belief that the one thing no one can take away from anyone else is the ability “to choose one’s attitude in any given set of circumstances.” I can't say mine has been a conscious choice. Mostly, I'm just watching what happens as these days and months and years pass by.