86 posts categorized "Cancer"

Cancer Tests and Magic Mushrooms

Wow oh wow oh wow oh wow.

After all your wonderful well-wishes on Friday's post, I wish you could have been there on the telephone with me and my new oncologist Friday. As we were getting through the preliminary niceties, he interrupted us saying, “Let me get to the point first.”

The thing about that is you wait and wait and wait, rocketing back and forth between fear and confidence, and suddenly the answer is right there, right now.

Sharp intake of my breath on my part and then he says – this is close to verbatim:

“The CT scan shows the size of the lesions in your lung have decreased by half and some are no longer detected at all. The one lesion in your peritoneum is not visible.”

This does not mean the cancer is curing itself. It means the chemotherapy is doing what it is supposed to do – slow the growth of the cancer to give me longer healthy time to live.

The doctor is so encouraged that if the news is as positive when the next scan takes place in two months, he will extend the scan interval to three months.

For now, however, Wow oh wow oh wow oh wow.

Chemo continues every two weeks until it doesn't work anymore. No one knows how long that is – it's different for every patient. But I'm encouraged now that I will still be here for my 78th birthday in April. For a long time I didn't believe that.

A couple of comments last week are of some concern to me. In one of them, the writer says that since I was fearfully anticipating the test results, my psilocybin session that freed me from my paralyzing fear of dying, must have failed.

Perhaps the writer doesn't understand that humans can't live with two and more emotional conditions, even strong ones, at once. I thought everyone knew this.

I can be, and was simultaneously, scared of test results and not afraid to die.

He also suggested that to maintain the results, I would probably have to have regular psilocybin trips. I don't suppose it would hurt and I have supplies for micro-doses but it certainly hasn't failed for me although I don't know about other people.

Speaking of psilocybin and other psychedelics used as therapy for depression, anxiety and PTSD among other conditions, I was surprised and pleased to see that in at least one survey, a majority of Americans support the use of these drugs for treatment.

As reported at YouGov that conducted the survey in 2018,

”Despite the stigma surrounding these controlled substances, new data from YouGov shows that many Americans are ready to embrace psychedelic therapies.

“What’s more, a relationship appears to exist between higher levels of education and increased support for psychedelic research and treatments. At each increasing level of education, there's a corresponding increase in support for medical research into the potential benefits of psychedelic substances, such as psilocybin mushrooms, MDMA, and ketamine.

“53% of all respondents support medical research into psychedelic drugs, and this number increases to 69% for respondents with graduate degrees.”

Here is the YouGov chart on support for psychedelic therapies among education levels:


Both the state of Oregon and the city of Denver already have ballot measures approving such use of these drugs ready for a vote in the 2020 election.

You can read more at YouGov.

Again and from my heart, thank you for your many words of love and support through not just this latest test scare, but for the entire 20 months so far since my original diagnosis of pancreatic cancer. I love you all.

Oops. Sorry About My Wednesday Mistake

On Wednesday, I told you I would get the results of my latest CT scan yesterday, Thursday. Wrong.

Right here on the desk in the notebook where I keep important information from meetings with doctors and nurses, in big, black letters, it says:

“Dr. will call Friday with scan results.”

I would like to blame chemo brain for my mistake but it had been two weeks since my last treatment so that is probably not the cause. Chemo brain can make you stupid for a few days but it had subsided by the time I was screwing up the Wednesday post.

So, assuming I do hear the results sometime today and to spare you, kind and gentle readers, any test-results-wait-anxiety I may have infected you with on Wednesday, I will slip in the salient information on the Interesting Stuff post tomorrow.

Meanwhile, I ran across a recent BBC story about “cancer cliches” - words and phrases that many cancer patients reject.

We discussed this a bit last August when I explained why I dislike phrases like “battling cancer” and “fighting cancer”. BBC cites a survey of 2000 people who have or have had cancer, reporting that I'm not alone.

”Calling a person's cancer diagnosis a 'war' or a 'battle' and saying they had 'lost their battle' or 'lost their fight' when they died, were other unpopular descriptions, according to the poll carried out by YouGov.

“Articles in the media and posts on social networks were found to be the worst offenders for using such language.

“Mandy Mahoney, 47, has incurable metastatic breast cancer...Mandy said it was not necessary for people to 'swallow a textbook and come up with all of the key phrases' to talk to someone with cancer, and it is fine to not always know what to say.

"'If you tell me it's awkward and you don't know what to say I will find a way to make that right for you, and actually on some occasions I might say 'we don't have to talk about it'.

"'But just be real.'"

There is more detail and a different opinion from a body builder at the BBC site.

I know there are a number of TGB readers who have or have had cancer. How you do you feel about these words and phrases?

A Week of Worry

While some of you are reading this today, I am at the medical center to drop off a couple of vials of blood with the phlebotomists (wonderful word), meet with my new oncologist and then undergo an ultrasound scan to (gulp) determine if the chemo I've been taking for two months is doing what it is meant to do.

What that is, is to slow the growth of the cancer – it cannot cure the cancer - thereby giving me some number of extra months of healthy life.

Because the scan happens every two months, it is easy to forget about it for six or seven weeks and get on with everyday life.

But not this week.

My previous chemotherapy regimen failed at its job so I know what that conversation with the doctor is like.

This is my first scan since the new chemo began and I'm nervous. You might even say scared. How about frightened, terrified and unnerved?

They all apply and sometimes, this week, it had been hard not to cry. Anticipation is a bitch.

There is no dearth of advice on coping with what a couple of websites call “scanxiety” - itself a grossly inept attempt to make light of a serious health predicament.

Worse, the advice itself doesn't improve things. It ranges from surrounding oneself with positive people and thinking of scans as maintenance (clearly written by someone who never had cancer) to this deeply misleading nonsense:

”Even when we do find that cancer has spread, we can usually craft a plan to control the disease so it doesn’t continue to spread and cause more problems.”

Not true.

Which leaves me exactly nowhere except to tough it out. I wish it were not so but I'm pretty sure that a not small percentage of you, dear readers, have been exactly where I am right now. Somehow we survive the anticipation.

I'll let you know what the scan reveals.

Living and Dying

Well, I've gone and done it again - read yet another book on dying when I said I wouldn't do that.

This one, titled Dying: A Memoir, by Australian writer Cory Taylor who died of melanoma in 2016, is a whole lot more autobiography than death but there are a few points that resonated with me.

Taylor's book is not the only one that speaks about working through anger as a universal response to a medical death sentence.

Most books about death do that but I've never experienced it and as I may have mentioned in the past, the one thing I have learned all on my own through 77 years of life is that if it happens to me, it happens to thousands, millions of others.

I'm pretty sure that just as we each find our own way to live our lives and no two are alike, that applies to dying too – at least for those of us who are privileged to be given some time to contemplate this monumental transition into the unknown.

I've never asked myself, “Why me?” That is not to say I'm more virtuous than anyone else; it just doesn't occur to me. I'm more likely to ask, “Why not me?” and perhaps that's related to the fact that everyone in my family dies of cancer. What else should I expect.

Another assumption in much of the writing about dying is that we-the-dying spend a good deal of time reflecting on our pasts. Really?

Once again, not me. I've been parsing my past for all these 77 years. I know my regrets, I've made as much peace as possible with my transgressions, learned what life lessons I could glean and moved on.

How I feel about the past is how I feel about an award I once won. I wanted it badly and was thrilled when my name was called. But the next morning I was disappointed that I couldn't summon the same feelings of joy and excitement as the night before.

Of course not, I eventually realized. Because it was yesterday. What's on for today is what I cared about that morning.

A third concern of death writers – amateurs (those who are dying) and professionals (reporters and “experts”) - is dealing with unhappiness and depression.

That can't be easy but again, not me.

Some of my attention nowadays is taken up with the anticipation of death in the relatively near future. I'm almost accustomed to it now as an appendage to most of what rolls around in my head.

Which is usually about the day's priorities. I'm very much a live-in-the-now kind of girl which is to say, death sentence or not, is there something yummy for lunch?

Have I told you that food is a great, good advantage of my personal cancer predicament? As the nurses regularly remind me, keeping up my weight is crucial to my well-being so that I don't fall into frailty. That means I can eat pretty much any- and everything I please.

The higher the calorie count the better and it should include a lot of animal protein, fats of all kinds and most other stuff I used to think is unhealthy for me. Well, in fact it is still unhealthy, but as one of the oncology nurses told me, “The cancer will kill you faster than the diet.”

So keep eating. (I'm fairly certain there are a couple more orange cranberry muffins in the freezer.)

What I am finding, at least for the moment and subject to change over time, is that dying isn't too different from living. Certainly that “predicament” is never out of sight or mind, but for now it doesn't matter much in day-to-day life.

Yes, I count out my pills once a week, I show up for chemo sessions and worry a bit about what a new scan will show about how or if the chemotherapy is working while ruminating on this ultimate existential quandary.

It doesn't feel too much different from life before diagnosis.

Letting Go When it is Time to Die

In last Friday's discussion here of physician-assisted death, reader Mary left, in part, this comment about who should have the right to use this service:

”I’d take this even further than if one is terminally ill,” wrote Mary. “I would definitely include Alzheimers. I would want the choice to be able to end my life if I was just old, tired, not feeling well and simply ready to go having had a good long life.”

This got me thinking about my Great Aunt Edith.

She was a fascinating woman, ahead of her time by miles but today isn't the place for her full story, just the end of it.

For 20 years or so leading up to Aunt Edith's death at age 89, I in New York City and she in Portland, Oregon spoke on the phone for an hour or so every weekend.

We talked about everything under the sun and although current affairs and politics were high on our agenda, there were books and movies and recipes and and all sorts of things to talk about. We never ran silent.

In between, Aunt Edith snail-mailed (no internet yet) me New Yorker cartoons, magazine and newspaper articles and other assorted information she wanted to share with me.

It was a lively relationship even at such a long distance from one another.

After many years, I noticed some slippage in her interests. Fewer snailmail envelopes came my way. Occasionally, she lamented that her old eyes got too tired to read easily anymore or even watch television sometimes. Her political opinions became fewer and more muted compared to the past.

This didn't happen all at once. In fact, by the time I noticed it, it had been there for months, slowly expanding – or, perhaps, I should say contracting. After a year or more, I realized that she was gradually letting go of the world around her.

Her interests continued to diminish until not too far short of her 90th birthday, Aunt Edith died.

Ever since then, I have hoped for a similar death, that when it is time to go, like Aunt Edith, I will have lost interest in the worldly things that engage me and lead me now.

Well, at least until the demise of the Trump era presents itself. I will be mightily pissed off to miss that.

Which brings me back to Mary's desire:

”I would want the choice to be able to end my life if I was just old, tired, not feeling well and simply ready to go having had a good long life.”

My first thought when I read that was, “Of COURSE that should be true.”

One of the things that is hard about being old in the United States, is that the “rules” - that is, the types of care and care homes, medical procedures, medications, health advice and government policy decisions affecting old people are made by people who are not old, who have no personal experience at growing old.

A whole lot of them think they know what is best for old folks. But aside from professional caregivers, they do not. The ultimate decision makers – politicians and corporate honchos – don't know and I don't think they much care either.

One example, pharmaceutical companies hardly ever include people older than 50 or so in drug trials so physicians have no idea how dosages should be adjusted for old people's bodies that function differently from younger adults.

And in the six or seven U.S. states that allow physician-assisted death, the politicians who drafted the legislation severely restricted the circumstances under which it may be used.

Why in the world should this be so? Whatever one's physical and health condition, why shouldn't people be allowed to end their lives when the time feels right to them?

Some have argued that people can shoot themselves or stop eating or chase down other means of dying. But why should they when there is a humane way to death not involving shocking violence or difficulty in carrying it out?

In monitoring myself since my cancer diagnosis 20 months ago, I've noticed a reduction in the intensity of some of my interests. I've dropped many political, current events and even health and ageing newsletters I've read regularly for years.

It feels similar to what I saw with Aunt Edith gradually bowing out of her engagement with life and the world around her.

I am convinced that I have been going through the early stages of this disengagement and I will know better than anyone when it is time for me to go. I've made all the assisted death arrangements with my medical team but I can do it only in one circumstance: when doctors decide I have fewer than six months to live.

Maybe that's not the right time for me. And anyway, why should the state care or regulate when an old person wants to take his/her leave?

Physician Assisted Death

It's also called “Death with Dignity” and “physician-assisted suicide” among another name or two. What is important to know is that it is NOT the same thing as euthanasia which is, by definition, understood to mean that a physician acts to end a patient's life.

Generally, I use the phrase “physician-assisted death” rather than “physician-assisted suicide” because “suicide” is such a loaded word. Also, “Death with Dignity, which is catchy, seems pretentious. Better to just say what it is plainly and simply.

Physician-assisted death, by whatever name, refers to a physician supplying the means of death but with the patient administering the lethal medication. This is legal in seven U.S. States: Oregon, Washington, Vermont, Montana, Hawaii, California, Colorado, and Washington, D.C.

Oregon, where I live, was the first state, in 1997, to legalize physician-assisted death and I'm grateful to have that choice which I will use, depending on circumstances, when the time comes.

In Oregon, it is called the Death with Dignity Act (DWDA). You will find the full statute here.

And these are the are the most salient points of how the law works, from the oregon.gov website:

”The patient must make two oral requests to the attending physician, separated by at least 15 days.

“The patient must provide a written request to the attending physician, signed in the presence of two witnesses, at least one of whom is not related to the patient.

“The attending physician and a consulting physician must confirm the patient's diagnosis and prognosis.

“The attending physician and a consulting physician must determine whether the patient is capable of making and communicating health care decisions for him/herself.

“If either physician believes the patient's judgment is impaired by a psychiatric or psychological disorder (such as depression), the patient must be referred for a psychological examination.

“The attending physician must inform the patient of feasible alternatives to the DWDA including comfort care, hospice care, and pain control.

“The attending physician must request, but may not require, the patient to notify their next-of-kin of the prescription request.

“A patient can rescind a request at any time and in any manner. The attending physician will also offer the patient an opportunity to rescind his/her request at the end of the 15-day waiting period following the initial request to participate.”

As you can see, the requirements are fairly strict. Further:

”The law does not require the presence of a physician when a patient takes lethal medication. A physician may be present if a patient wishes it, as long as the physician does not administer the medication him/herself.”

You can find pretty much everything you want to know about Oregon's DWDA here.

TGB reader Elizabeth Kurata reminded me this week about an Oregon couple who, in 2017, chose to use the state's DWDA law to end their lives together. As Time magazine reported:

”On the last morning of their lives, Charlie and Francie Emerick held hands. The Portland, Ore., couple, married for 66 years and both terminally ill, died together in their bed April 20, 2017, after taking lethal doses of medication obtained under the state’s Death with Dignity law.

“Francie, 88, went first, within 15 minutes, a testament to the state of her badly weakened heart. Charlie, 87, a respected ear, nose and throat (ENT) physician, died an hour later, ending a long struggle that included prostate cancer and Parkinson’s disease diagnosed in 2012.”

The couple had allowed one of their children, Sher Safran, to make a documentary about the end of their lives, Living and Dying: A Love Story. Here is the trailer:

You can watch the full 45-minute documentary at Vimeo.

Is physician-assisted death a choice you would make for yourself?

Cancer and Mood Changes

Did you ever wake up in a bad mood that affects you all day? Was it a dream that caused it? Hormones? Something you ate? Who knows?

Other times you can – sort of – identify the cause: you're frightened about something or worried or sad or unhappy for reasons that are generally obvious. Aside from chronic depression (which news stories tell me is widespread), dark moods eventually lift and we move on.

Nowadays, since I was diagnosed in October with inoperable cancer, I can easily identify the cause of black moods: it is the aftermath of chemotherapy, those days when I'm physically unwell that produce grim thoughts and feelings.

That's when I become convinced I will die before the day is out, before I have finished notes for my healthcare proxy and beneficiary to help her find all the information she will need.

It's when I imagine I will die before anyone thinks I will and lie rotting in my bed until someone wonders where Ronni is.

It's when I can't read or watch television because my deep, dispirited mind tells me there is no point to doing anything because I will be dead soon.

Yes, I know I have told you about how much I believe death is part of life, about how curious I am about these last weeks and months, and how lucky I am to have this have time.

But I also have days with dreadful thoughts that drag me down below where I think I can ever crawl back out again.

At the time, this always feels more real that the good times - until...

Like Saturday morning when the chemo fuzziness and fatigue lift and I'm a normal person again. (And no, I don't need any advice - I'm just reporting the weather from the frontier.)

Fighting Cancer

Is cancer, do you think, the most dreaded word in the English language? If it's not, surely it is in the top five.

Nobody wants to hear that – cancer - about themselves or anyone they love and in my case, when they first told me about my pancreatic cancer in June 2017, it took awhile for me to believe it.

People may not have noticed before but once they are diagnosed and weighing potential treatments they hear a lot about “fighting” cancer. On television commercials, at websites for support groups, on teeshirts and from other patients too. “I'm going to fight this thing,” they say. “I'm going to beat it.”

A year and a half later I'm still wondering what that means, to “fight” cancer. I can't punch it in the nose. Or chase it out of town. Perhaps I'm supposed to be extra vigilant in some secret way to keep it from killing me.

Early on in my cancer odyssey, I rejected the ubiquitous vegetable diets that promise to cure cancer, along with suspicious clinics in other countries. (Do not ever forget: if there were a cure for cancer, we would all know about it.)

I was (and still am) being treated at a world-class cancer center and I figure these doctors, nurses and surgeons know a whole lot more about cancer than I could ever learn on the internet.

So I listened to them. I still do. And I do what they tell me.

The massive Whipple surgery gave me about 10 cancer-free months before two new cancers showed up. There is nothing to help, the doctors tell me now, except chemotherapy that may delay the growth of the cancers for awhile to give me some more healthy time.

So as long as the chemo gives me more good days than bad, I'll continue with the doctors' advice. But “fight” cancer? Not me.

I still don't know what it means I should do but it sounds like it would wear me out or make me unhappy. I feel healthy still most of the time and I want to live the time I have in the best possible ways. Fighting doesn't fit that.

I'm still curious, however, about what people mean when they say that.

In the Space Between Life and Death

Leafing through the notebook where I record information from meetings with various physicians and nurses, I found several estimates of the time I have left on earth. They have different shadings of meaning.

One tells me that if I had rejected the chemo I now take every two weeks, I'd have nine to 12 months. Another says six to eight months WITH chemo. A third thinks the chemo will give me up to a year. And so on.

Of course, these are guesses. But they are based on these professionals' experience with many cancer patients and the differences come in because each patient's body is different as is each cancer.

This only points out that however much we want to believe we have control over our lives, we do not. (Leaving physician-assisted suicide available in a few U.S. States and other countries aside), death will find each of us when he or she decides our time here is done.

Following my terminal cancer diagnosis, I have gradually come to spend my time now in a middle space between life and death. Or, sometimes, in both places at once.

Living has become both larger and smaller. Smaller in the sense that I don't much want to go anywhere. I have no bucket list and unless someone is paying for a first class ticket, I'm never getting on an airplane again – it's inhumane the way the airlines pack people into coach.

At home, I love spending time with friends and soon, with my newly-found son and his family when they move to a new home near me. I am also dismayed in the best possible way by the people who have offered to help. So far, I haven't needed it, but the time will come when I will.

Small pleasures I've enjoyed for much of a lifetime have become even more precious. Letting hot water flow over my body in the shower for longer than I should. The way the morning sun shines through the living room windows. The murder of crows (or ravens or blackbirds; I don't the difference) who yell at each other in the parking lot here most days make laugh every time.

I smile and laugh at a lot more things now than I did before this happened.

On a much larger scale, I am spending time with the greatest mystery of humankind, the one we try to ignore for most of our lives: that we all die.

Although the sense of peace about dying along with the understanding I gained in my psilocybin session that death is sort of like the other side of life and not something to fear has stuck with me, my mind sometimes wanders to the idea of my no longer being here.

“I” live in this particular building. “My” stuff is gathered in this space. “I” move around, “I” talk to people, “I” go places, “I” have an impact on others as they do on me. Can that “I” just disappear?

As hard as I try, I cannot imagine a world without me. The morning after my psilocybin session, I asked my guide over breakfast if s/he can imagine the world without being in it.

The guide thought carefully about this for several minutes and said no, couldn't do it. And this is a person who has been using hallucinogens and guiding others through sessions with them for a couple of decades.

I have dark periods when I think about the day I die and sometimes the thought gets really stupid. Don't laugh, but if I choose to use Oregon's physician-assisted suicide law, I have wondered what I would wear that day. What clothes do I want to die in.

Do I want to be in bed or in a chair or lounging on the sofa? Oh, come on, Ronni. Where do these thoughts come from? It's usually on the couple of days that heavy fatigue kicks in after chemotherapy.

Even with all that, what I have noticed about myself in the three weeks since the psilocybin session is that the peacefulness I now have in relation to dying has extended to daily life.

It shows up in that old phrase about taking time to smell the roses. I feel like an idiot saying that but I've mostly been in a hurry all my life. I'm not anymore. I'm more comfortable day-to-day than I've felt in most of life and its not too much of a stretch to say that this space where I am now between life and death is among the happiest of my life.

Some Things I'm Finished With Forever

It's not just shopping, as I mentioned on Wednesday, that I can give up with this terminal cancer diagnosis. There are a bunch of other things I never need to think about again and I'm pleased as punch to let them go.

Back in early October my oncologist, the chief hematology nurse and a social worker gathered in a room to tell me that my two new cancers could not be cured but that certain chemotherapy might extend the amount of “healthy” life I would have before symptoms of the cancers begin to take over.

My first thought then was, “A-a-a-ll R-i-i-ight! I just went through my exercise routine for the last time ever this morning.”

For years and years, at least five days a week, I had hated every moment of every workout and I'm happy to be done with it.

Here are some of the other things I have ditched:

I don't need to worry about getting dementia anymore.

I can eat anything I want. In fact, that chief hematology nurse has impressed on me more than once that I need to keep my weight up to avoid frailty.

So I can eat all the high calorie, high fat food I want and in fact, she told me not to worry that it may be unhealthy, that the cancer will kill me long before the diet would.

No need to bother to learn the metric system now.

I can stop feeling guilty about not texting. It's just not my thing.

No more major dental work.

I can stop worrying that I am hopelessly behind in keeping up with new music and movies. I have no reason to care now.

Think of all the time that list frees up. If you've got any suggestions of what else I might give up, I'm eager to hear and will consider them all.

Shopping With Terminal Cancer

It's impressive, I've discovered, how a terminal diagnosis simplifies one's life. Today's little change in how I now spend my time was a surprise. It snuck up on me having been in effect for awhile before I realized it.

In fact, it might not even be worth mentioning except that I think it could be one of the ways people in my predicament (and possibly others) begin to disengage from the world around them in increments to be able to leave peaceably when the time comes.

For starters, in the past few weeks I've been clearing out my email subscriptions so that many fewer show up in my inbox.

One category is news and politics. Do I really need four newsletters from The New York Times and an equal number from the Washington Post? Hardly. Headlines are enough.

That applies to 40 or 50 other publications I've now pared down to one email each and unsubscribed altogether from about three-quarters of them that are duplicate points of view.

It was a shock to find out that I had 103 Google Alerts on a variety of political and ageing topics, each one of which dropped an email on me at least weekly and often daily. I certainly didn't read most of them.

I've kept only 11.

Gone too are computer- and internet-related newsletters. I don't need to know that stuff anymore. Also music, TV and movie promotions. I don't spend much time with those now. Besides, I have access to more than enough to keep me entertained.

But the biggest category of email I've dropped is shopping. Undoubtedly you know how that works: every place you ever bought anything online, even once 20 years ago, emails adverts forever and sells your email address to a bunch of other retailers who also email you and sell your address and so on – it piles up over the years.

Worse, retail may be the biggest category of website I've noticed where many do not honor unsubscribe requests. I got fed up trying and now I just label them all junk so they don't land in my inbox.

Here's what I've learned about shopping while terminally ill:

The only things I need to purchase now are food and bathroom tissue. You can quibble over such items as toothpaste but you get the idea: Necessities only. I've never liked shopping in general and now I've lost all interest.

I don't need to buy clothing ever again. Books too, unless wildly compelling; there are already too many unread ones in my house that won't get read before I die.

The computer and related paraphernalia will last until I'm gone. There is no reason now to replace bedding, towels, kitchen equipment, worn furniture, carpeting or any kind of decorative item.

I'm done with all that and happily so while thinking it would have been smart to have applied some of these measures for the past 40 or 50 years. Oh well – too late now.

But wait. My shopping abstinence is not total and I cannot explain why this happened:

Long before my cancer diagnosis – maybe four or five years ago – I saw a rocking chair online I wanted. Then I thought better of it. Until I didn't and I stared at it on my computer screen from time to time. Years went by in this manner.

The rocking chair came to mind again shortly after the doctors told me there is no treatment for my cancer. For reasons I haven't worked out, I still wanted it – strange when your personal sell-by date is imminent - but there you are; we humans are nothing if not inconsistent.

And so it arrived yesterday.


And now, having reduced my computer screen time by ridding myself of hundreds of emails a day, I'll have plenty of time to use the rocker of an evening by the fire.

Magic Mushrooms, Cancer and the End of Life – Part 2

[Part 1, a backgrounder on psilocybin – aka magic mushrooms - is here. If you have not done so, I urge you to read that before this post.]

* * *

On the day before Christmas last month, I traveled to the home of a guide who would, the next day, be at my side during the five or six hours of a magic mushroom session.

In the years before I was diagnosed with cancer, I had followed reports of research into psilocybin therapy for terminally ill patients and determined that if I ever found myself in that predicament, I would seek to participate.

And so the predicament came to pass.

By December, I had been searching for a magic mushroom guide for a month or two – not an easy trick as psilocybin is illegal, designated a Schedule 1 drug (along with heroin, LSD, ecstasy, etc.) by the U.S. Drug Enforcement Agency (DEA).

I had been anticipating having to muck about in the illicit drug market, of which I have no useful knowledge, but the universe smiled on me when out of the blue, an old friend with whom I had never discussed such matters asked if I was interested in end-of-life psychedelics.

How does something like that happen? And at just the right moment? It's a mystery to me but one of several things recently for which I have no explanation.

My friend put me in touch with a guide and after a long and interesting telephone conversation, the guide and I arranged the time and place for my session.

Over dinner, we spent the first evening discussing how the session would work the next day and the guide asked what my goal was, what I wanted to learn during my “trip.”

As I explained then, I was seeking relief from the fear and terrors that has been plaguing me since my terminal diagnosis in early October. I wanted to find acceptance of death as a normal part of life, gain some peace with the inevitable along with, if possible, some insight to the meaning of life and death.

The next morning, I ingested a measured amount of dried, crushed psilocybin mushrooms mixed with a small amount of ice cream and we moved into a large, beautiful, serene room overlooking a woods in which the background music the guide had selected seemed to me to be just right.

And here is where I get into trouble trying to tell you about what happened over the next five or six hours. It is impossible to do that without sounding like a hippie dippy doofus out of the 1960s.

Fortunately for me, I am not alone. The man who wrote How to Change Your Mind, last year's best-selling book on psychedelics, Michael Pollan, had the same difficulty, as he explained in an article in The New York Times a couple of weeks ago. Some excerpts:

”William James famously wrote that mystical experience — perhaps the closest analogue we have of a psychedelic trip — is 'ineffable': beyond the reach of language. I couldn’t count on a common frame of reference, since not all of my readers would be familiar with the exotic psychic terrain onto which I wanted to take them...”
“Taking notes during my journeys proved futile. I couldn’t summon the will, and the very effort seemed like a violation of my guides’ first commandment, which was to surrender to the experience.

“So instead I asked them to write down anything I might say. This yielded a handful of mostly useless notes, consisting of vague superlatives like 'Spectacular!' or gnomic utterances like 'I don’t want to be so stingy with my feelings.'”
”What do you do with an insight like 'love is everything'? I wondered aloud. 'Is a platitude so deeply felt still just a platitude?' No, I decided: 'A platitude is precisely what is left of a truth after it has been drained of all emotion. To resaturate that dried husk with feeling is to see it again for what it is: the loveliest and most deeply rooted of truths, hidden in plain sight.'”

I quoted all that so you won't think I am too much of a hippie dippy doofus – or, at least, not the only one. (There is an excellent interview with Michael Pollan about a lot of this at Fresh Air With Terry Gross.)

A portion of my trip – though I have no idea of the length of time, long or short - involved many doors into empty white rooms. It wasn't entirely that but I don't remember visuals so much as impressions and feelings and maybe some insights to my life.

There were moments of supreme beauty for which I have no words and a strong sense of wellbeing, of connectedness to all living beings and to the universe.

After passing through many doors, I came to one that seemed identical to the others but when I walked through it, a strong sense of peace and contentment enfolded me, and an understanding that dying and living are inseparable; that there is nothing to fear.

And that's the best I can do to tell you what happened.

The next morning, the guide took me through a period of integration guessing correctly that I, being who I am, would be prone to dismiss my experience as not real.

She brought me around to believing otherwise and I have been able to hang on not just to the sense of connection, but to the sense that dying is as normal as living – that they are the same.

So far, since returning home, I have not had any of the terror attacks I'd experienced before the magic mushroom session.

And none of that even begins to explain what happened to me with my guide that day.

Caroline Dorsen, an assistant professor at NYU Rory Meyers School of Nursing, in an interview last June had this to say about her research into guided psychedelic sessions. There is, she says,

”...an underground — and understudied — community of people...helping others to use plant-based hallucinogenic drugs. In guided sessions or ceremonies, facilitators administer drugs like ayahuasca or psilocybin to people looking to alter their consciousness and improve their mental health...

“...plant medicine use is all about facing life’s difficulties in a safe and supportive environment. Used in the context of community and ritual, ingestion of plant medicines (like ayahuasca and psilocybin mushrooms) is seen as a powerful healing modality.

“Ingestion of these plants is taken very seriously and the ability to use them is seen as a privilege.”

Yes. I consider my psilocybin session to be an extraordinary privilege that has redirected my end-of-life journey onto paths I could not have found on my own or without my guide. I am deeply grateful to the universe for dropping this experience into my lap when I had no idea where to turn, and I am exploring a whole new set of assumptions now about living and dying.

There is more than a bit of the sacred about this.

Magic Mushrooms, Cancer and the End of Life – Part 1

As you might imagine, a diagnosis of terminal cancer can and does produce high levels of depression and/or anxiety in a large number of patients. Not to mention freaking, mind-bending fear.

I have, over the past two months or so, had debilitating attacks of dread that seem to rattle every cell in my body and leave me terrified.

Such responses are so well-known that for some time now there have been research scientists who are working to find ways to relieve these fears and anxieties.

A few years before this cancer predicament presented itself in my life in 2017, I began tracking reports of these studies. Most of them involve a person's ingestion of psilocybin, known colloquially as magic mushrooms.

You might recall that psilocybin, along with marijuana, mescalin and a few other hallucinogens, are among the substances many of our generation who were interested in altering our consciousnesses experimented with in the druggie 1960s.

Besides smoking pot regularly, I took three acid (LSD) trips back in those days. They were fascinating.

One of the most well-known, recent psilocybin studies took place at Johns Hopkins University School of Medicine in Baltimore, Maryland. From the medical journal report's introduction (emphasis mine throughout this post):

”Cancer patients often develop a chronic, clinically significant syndrome of psychosocial distress having depressed mood, anxiety, and reduced quality of life as core features...In cancer patients, depression and anxiety have been associated with decreased treatment adherence...prolonged hospitalization...decreased quality of life...and increased suicidality...

And from the conclusion:

”The data show that psilocybin produced large and significant decreases in clinician-rated and self-rated measures of depression, anxiety or mood disturbance, and increases in measures of quality of life, life meaning, death acceptance, and optimism.

“These effects were sustained at 6 months. For the clinician-rated measures of depression and anxiety, respectively, the overall rate of clinical response at 6 months was 78% and 83% and the overall rate of symptom remission was 65% and 57%.

“Participants attributed to the high-dose experience positive changes in attitudes about life, self, mood, relationships and spirituality, with over 80% endorsing moderately or higher increased well-being or life satisfaction.

“These positive effects were reflected in significant corresponding changes in ratings by community observers (friends, family, work colleagues) of participant attitudes and behavior.”

If you have a tolerance for charts, statistics and scientific jargon, you can read the entire report here.

Another cancer-psilocybin study at New York University (NYU) concluded that a

”...single moderate-dose psilocybin (in conjunction with psychotherapy) was safely administered to a cohort of patients with cancer-related psychological distress (e.g. anxiety, depression).

“It produced rapid and sustained anxiolytic and anti-depressant effects (for at least 7 weeks but potentially as long as 8 months), decreased cancer-related existential distress, increased spiritual wellbeing and quality of life, and was associated with improved attitudes towards death.

You can read this entire report here (with similar statistics, charts and jargon as the Hopkins study). There have been and are ongoing other studies producing remarkably similar results.

Something big is going on with psilocybin. You may have heard of or even read Michael Pollan's 2018 book, How to Change Your Mind, about what he calls the “new science of psychedelics.” I don't want to bury you in long quotations, but here is part of his response to his psilocybin research, having also tripped on it himself:

In a follow-up to the NYU study, Pollan reports,

”A few key themes emerged. All of the patients interviewed described powerful feelings of connection to loved ones...and, more generally, a shift 'from feelings of separateness to interconnectedness.'

“In most cases, this shift was accompanied by a repertoire of powerful emotions including 'exalted feelings of joy, bliss, and love.' Difficult passages during the journey were typically followed by positive feelings of surrender and acceptance (even of their cancers) as people's fears fell away.

With evidence of such positive results piling up, you wonder why psilocybin is not made available to terminally ill cancer and other patients. The reason is that the U.S. Drug Enforcement Agency (DEA) lists it as a Schedule 1 drug: no prescriptions may be written and limited use is allowed for study.

That may be changing. Efforts are underway in Oregon and Denver to decriminalize magic mushrooms:

”Advocates with the Oregon Psilocybin Society received formal approval last week to move ahead with their language for a 2020 state ballot initiative that would reduce criminal penalties on psilocybin and allow for its use during 'guided sessions' at state-licensed facilities,” reports Vice News.

“Decriminalization efforts have moved a little further in Denver, where advocates have already started gathering signatures to put an initiative of their own on the municipal ballot in May 2019 that would decriminalize personal use, possession, and growth at the local level.”

Okay. Now you've got some background on magic mushrooms. Part 2 is here.

Observing the End of Life

”I count it as the greatest good fortune to have these few months so full of interest and instruction in the knowledge of my approaching death.”

- Alice James in a letter to her brother, William

Isn't it comforting, even thrilling sometimes, to learn that others who came before you, especially those for whom you have great respect, have thought or felt what you are thinking and feeling.

In the past, before the doctors told me my cancer is terminal, I thought the minutes surrounding the moment of death would be the last great adventure of life. I hoped to be alert and unencumbered with pain so to be able to know the experience as it happens.

As I have come to see now, my former vision of the end is puny. Too cramped. Too small. There is much more to dying than a single moment.

There is, if you are fortunate enough to be made aware of your coming demise, the entire third act of life - the one we, in much of the western world, ignore - the period of dying.

Another who came before me, the late Scottish novelist, Muriel Spark, speaks well to what I have come to believe:

”Death, when it approaches,” she wrote, “ought not to take one by surprise. It should be part of the full expectancy of life.”

However short or long my remaining days may be, it is a great gift I have received, knowing my death is near. It led to what I think is the most important question in the circumstance: what do you want to do with the time that remains?

I had asked that question before but my answer then was not adequate. It has become more complex now that my sensibility about death itself has changed. (More about that soon but not today.)

What I realize now is that I like my little life just as it is. No bucket list. No great unfinished tasks to rush to complete. Just to continue what I have been doing these past few years:

• Keep up this blog for as long as I can or want (my work)

• Spend time with the people who mean the most to me (my pleasure)

• And, do what I have always done when new and interesting things turn up in my life: find out what others know about them, observe and learn (my satisfaction)

In this case, what most engages me for the moment is the question of what living is like when you know you will soon die.

One way I have been working on that is, from time to time throughout a day, to move my consciousness off to one side of myself and watch. Allow myself to do whatever I'm inclined to do without directing it and to observe how I become different, or not. To become both the observer and the observed.

What I am curious about is how does this knowledge of impending death change me and my behavior? Am I frightened? How do I help make that better? What do I believe about life and death? Does it alter my relationships with the people I know? Do I do things differently or do I do different things?

And about a hundred other questions.

Then, sometimes, when I think what I have observed is interesting enough, I will tell you about it here.

For 15 years, the subtitle in the banner at the top of this page has been the topic of Time Goes By: “what it's really like to get old.”

Without my quite noticing for awhile, that changed in the past couple of months and now I've caught up with myself: the subject of the blog has morphed into what most interests me in these days: what is it like to die - to know I am going to die relatively soon and how I am navigating that knowledge?

There is no greater mystery to mankind than death. How, finding myself in this place, can I possibly ignore it.

So I suppose we could now call Time Goes By an end-of-life blog. That may be difficult for some readers and I understand if it is. But you can believe me that I am fascinated to be in this predicament and if you want to follow along, I will be pleased to have you here and to listen to what you have to say about it.

One more who came before me, the second secretary-general of the United Nations, Dag Hammarskjöld:

”Do not seek death. Death will find you. But seek the road which makes death a fulfillment.”

I'm working on it.

Anecdotes From the World of Chemotherapy

It's a rough day here on Tuesday as I write this – heavy fatigue from the new chemotherapy regimen I began last week has slowed me way down; I'm napping a lot.

In the past, I was lucky to need only about an hour's infusion; now it's five or six hours.

Actually, most of that time is taken up with infusions of medications to keep nausea and other side effects at bay. The chemo is only an hour or so at the end of the session.

But they thought up a new “treat” for me this time - wearing a chemo body pump at home for two days afterwards, like an across-the-chest pocketbook. It's about the size of a large cell phone plugged into the permanent port in my chest for an addition infusion.

Of course, I can't shower for two days – the pump must remain dry - so I try to keep my distance from people I run into because I'm probably kind of stinky for those days.

And it's just a joke getting in and out of clothes trying to keep that line from the pump to the port from getting twisted or yanked out while taking a sweater or nightgown off and on.

At one point I somehow got the line strung all the way through a sleeve and it took ten minutes to get that sorted out.

This is high-tech, modern medicine but sometimes you end up feeling like a three-year-old who doesn't know which shoe goes on which foot.

The thing is programmed to stop pumping after 46 hours after which I was scheduled to go to the clinic to have it removed.

Here's the fun part when that happened: So I'm working at the computer when the most ungodly loud alarm goes off. Truly screeching at me. The sound seemed to be coming from under the desk – you know, where that mess of cables that connects the computer and peripherals is plugged into the surge protector.

Clang, clang, clang, clang went the alarm like the loudest fire engine siren rattling my brain. Clang, clang, clang, clang. Fearing smoke or fire might erupt, I crawled under the desk with a flashlight and unplugged all the devices – all eight or ten plugs – while being careful not to bang into or lean on the pump, not an easy trick when you're mildly panicked.

Nothing. The screeching continued. Then I thought maybe it was coming from somewhere in the kitchen but nothing there was amiss. I stood around for a bit until dummy here (that's me) finally realized it must be the damned body pump.

Sure enough – I'd forgotten they told me it would “beep” when it was done. BEEP, you say? I'm still half deaf from it.

I finally managed to turn it off but if any of you know the difference between a Stop/Start button and an On/Off button, please do tell me. I punched both of them several times before the alarm finally stopped.

Or maybe it's just chemo brain that made my mind go too fuzzy to think straight.

I'm sure TGB readers who have themselves been through this and other unexpected complications of cancer treatment have your stories. As exhausted as we can be when these mishaps occur, the only useful way to deal with it is to just laugh at yourself, do the best you can and then go back to bed.

Crabby Old Lady on Honoring Cancer Survivors

Five year survival is the medical gold standard of a successful cancer cure and apparently there is a season of the year (December) to “honor” five-year cancer survivors as articles about several of these celebrations have recently dropped into Crabby Old Lady's email inbox.

Now, doing some light homework for this blog post, she has discovered that in June each year there is a National Cancer Survivors Day, “a celebration for those who have survived.”

Crabby would be ecstatic to be one of those people but her life hasn't turned out that way. Her two new cancers are incurable. And as you must have expected from the headline, here goes Crabby Old Lady again being a Grinch.

[Unpaid family and friend caregivers deserve respect too (not to mention some effective regulations about leave from work, etc.) but today is about professional caregivers.]

So. Honor the survivors? Give Crabby a break. It's fantastic when that five-year anniversary arrives and it should probably involve an over-the-top, joyous, hoot-and-hollerin' celebration with the survivor, along with his or her family and friends. But publicly “honoring” them?

When they should have been honored was during the months, maybe years of treatment. It's damned hard to be a cancer patient. Surgeries, chemotherapy, radiation, things that go wrong like Crabby's internal bleeds that required two more surgeries, pain, fatigue like you've never experienced before, keeping track of all the medications and more.

Celebrations back then might have given patients encouragement when they most needed it as they wondered, too often, if they just should have skipped all the interim stuff and died sooner.

That's when the honoring of patients would mean something - for following all the instructions and doing it stoically. Well, for the most part. Sometimes you just need to have a good cry.

But the first people Crabby honors, above all the patients, are the professional cancer caregivers. All of them, from celebrated surgeons who get so much attention, through the RNs, CNAs, medical assistants, schedulers and coordinators and all the rest of them.

At the top levels, physicians, nurses and their assistants (the dozens Crabby Old Lady has spoken with about their careers during her 18 months of regular visits with them) CHOSE to make their careers with cancer patients.

Think of that: they made a conscious decision to spend their working life with people who, most of them, die in a relatively short period of time.

Patients and caregivers get to know one another over that time. They exchange personal information unrelated to cancer. They don't become friends exactly, but they do become friendly with warm feelings for one another: “Hey Sean,” Crabby might say to a medical assistant when she arrives, one who had been previously assigned to her. “How are you doing?” Or “Hi Nancy. Good to see you again.” High fives all around.

She gets the same in return from the caregivers as she walks by their desks. And by name. How many of us do they keep in mind?

Imagine what it is like for them when all too often and not unexpectedly, they get word that one of their patients has died. If you think it is hard for laymen like Crabby and you to grieve for loved ones, it doesn't happen but a fraction of the time it does for cancer caregivers.

And yet, they choose this work and they are universally wonderful people in all respects – different in their essence than other people.

As Crabby or Ronni has said before, every single one is smart, knowledgeable in their field, warm, comforting, friendly and as far as Crabby can tell, never has a bad day. They never, ever bring their personal problems to work – at least not with patients.

Yes, Crabby herself has worked hard following instructions to get through her treatment – sometimes awful stuff – questioning not infrequently if it isn't time to stop and let the disease take its course. But these men and women keep Crabby going as if it really matters to them – and it does, manifestly.

These are the people Crabby Old Lady honors first above herself and other patients. They are different in the best possible way from the rest of us. Maybe it's in their genes.

The Alex And Ronni Show

Before we get to the latest edition of The Alex and Ronni Show, some housekeeping notes.

In the past couple of weeks, I've had some trouble breathing. The simplest things like bending over to tie my shoes or just taking out the trash can leave me heaving to catch my breath. Actually, it's been hard to do almost anything more energetic than sit at the computer these past days.

On Wednesday, my oncologist ordered a new CT scan which shows that the cancer in my lung is getting worse than expected at this point causing the shortness of breath.

A different chemo may help and the side effects, as they have been explained to me, are probably manageable. I'll begin next week and we will know within two weeks or so if it is helping.

As I think I mentioned not long ago, all my life I have kept journals with the goal of helping make sense of my world and figure out what I am thinking or believe. With this cancer diagnosis, I moved some of that to this blog and many of you have been kind enough to assert that these posts are a help to you and others.

To the degree that is so, I am grateful that my meandering thoughts and reports about my predicament have some value. Your comments buoy me, make me feel better and often contain useful information or, even better, make me laugh.

When I started this blog 15 years ago, of course I had no idea this is where it was heading. And I didn't know how important this “job” would become to me. I segued straight from work when I retired to this new work. I still love doing it and I will continue for as long as possible. It is what I do.

Some of you comment privately via email and I appreciate that too. But because of this latest cancer development and its effect on my energy, I can't get nearly as much done as before. Although I've tried (and mostly succeeded) answering all your email notes, I need now to take that pressure off myself.

So you're welcome to email me still, but I won't be able to answer anymore. I hope you will understand.

And now, here is the most recent Alex and Ronni Show recorded last Tuesday before I had received this latest cancer news.

Cancer Update – 28 November 2018

Because I'm at Oregon Health & Science University today for doctor appointments and a chemo session, it would make better sense for me to have saved this post for Friday or Monday. But it's been on my mind for a few days so why not.

What continues to amaze me is that I can be under a death sentence and still feel as good as I do. All cancers are different in different people but I did not understand before that it is possible for a terrible disease to be secretly ravaging your body while you go about your daily business unaware.

Not counting chemo after-effects, I wouldn't know I'm sick if the doctors hadn't told me.

Well, most of the time. It took two days after my previous two chemo sessions before the flu-ishness took over. I spent the following two days in bed feeling pretty much as I have with any past bout of influenza – aches, pains, sleepy, miserable - and then I got better.

That was the first time. The second time, the sickness lasted longer by a couple of days and following that, my energy has been the lowest I've felt since last year's surgery. Not to mention a few days later when out of nowhere my temperature jumped to 102F. But it was back to normal by morning.

Still, I have more good days than not and as long as that is so, I will continue the chemo. I know some cancer patients forgo chemo altogether and that's their choice. Mine, according to the doctors, slows the growth of the tumors and will give me six to eight months of reasonably good life before the cancer takes over.

And I definitely need the time. It's amazing how much work it is to die.

My end of life documents are in place. Arrangements have been made for my financial accounts to be available to my heir immediately following my death. She and I have regular conversations so she's aware of a good deal of what she needs to know.

Nevertheless, I am making a booklet for her with the details of all my household and other accounts, computer passwords, necessary email addresses, locations of important papers, insurance, auto information, etc. There is a whole lot more to do than I had realized at first thought.

And I still haven't arranged for my cremation. I can't tell you why that is and I need to get it done. For god's sake, it only takes a phone call.

Also on the list is to clean out all the detritus from the house. Guess how far I've gotten with that.

So these things, with the blog, are my days. I have no idea how other people in my predicament spent their time but I like my little life and want to keep it for as long as I can.

Oh, did I mention I lost most of my hair after the last chemo session. Do you recall that phrase people often use about their hair “coming out by the handful?” They aren't kidding. It's exactly true.

Four or five days after the chemo infusion, I was shampooing my hair in the shower and a huge handful came out. Then another. And another. And another leaving me with four or five hanks of hair hanging from unrelated areas of my head.

It was ugly so I chopped them all off and tried to even out what hair remains with the scissors. I have no doubt I'll lose the rest after today's chemo session. I have plenty of hats and a wig is also in my near future. I don't want to scare people with my bald head.

Day to day, I worry that the doctors will find reasons to stop the chemo before my six-to-eight months are done.

And I'm frightened some of the time in an overall, existential way that makes it hard to breathe. I may have a solution for that I'll tell you about soon.

Meanwhile, here's something I'll bet you didn't know about cancer: it takes away your cooking skills.

Okay, not exactly. It's just that I have lost all interest in and patience with cooking. After a lifetime of finding it to be an interesting, creative, not to mention tasty outlet, cooking has become way too tedious and time-consuming.

Nowadays, if I can't just heat it up in the oven or microwave, I'll eat a peanut butter sandwich. I am also investigating restaurant delivery services.

"Miracle" Cancer Cures

It's bad enough when you are diagnosed with cancer. Later, when they tell you it's untreatable, you think you've heard the worst. But you would be wrong.

What you didn't know before is that on the sidelines waiting for just the right moment to move in are the ghouls and charlatans.

The first email, sent via the “contact” link on this blog, arrived a few weeks ago. It wasn't from a name I recognized, not someone who comments or had privately emailed me before.

There is a treatment, the writer said, at a private clinic in California that cures cancer with supervised fasting over several months of residence at their luxurious spa.


Since then, four or five more cancer cures have arrived via the blog email from people who are strangers to me. One of them provided a link to a professional-looking website (anyone can pay to have that done.) featuring a movie-star handsome man that uses protons they say results “in strong cure rates.”

Another uses cancer immunotherapy to achieve long-term remission for years, “and even decades.” The latest hot cancer "cure" is cannabis that, it is claimed, shrunk a teenager's cancer cells after chemo had failed.

And so on.

In April 2017, the U.S. Federal Drug Administration sent out letters to 14 companies telling them “to stop making the bogus claims or face possible seizures of their products and criminal prosecution.” From the Washington Post:

”The letters covered more than five dozen unapproved products that the companies said could prevent, treat or cure cancer, the FDA said. The items included pills, ointments, oils, drops, teas and diagnostic devices.”

That list doesn't begin to cover the types of quack treatments from swindlers preying on people at the worst moments of their lives. Wikipedia has a huge long list of a hundred or more unproven and disproven cancer cures.

Several websites publish a simple list of frequently used phrases that should alert anyone to phony cures:

Treats all forms of cancer
Miraculously kills cancer cells and tumors
Shrinks malignant tumors
Selectively kills cancer cells
More effective than chemotherapy
Attacks cancer cells, leaving healthy cells intact
Cures cancer

Another phrase charlatans commonly use – alternative – is particularly insidious because there is a real place for alternative treatment to complement legitimate cancer medications. The Mayo Clinic has a handy chart about that:


Let me be clear about “miracle” cures: if anything cured cancer, WE WOULD ALL KNOW ABOUT IT. It would not be a secret. Someone would already be rich and getting richer from it.

Cancer patients are desperate, hoping against hope that the diagnosis is wrong, that a different treatment will magically work, that someone has the secret ingredient to give them more days, months, years of life. These are not foreign concepts to me recently.

But make no mistake, the people who sell useless, sometimes dangerous, unproved treatments are evil, depraved and cruel. What they do is a form of faith healing (at least one uses real snake venom) tricked out as medicine and they make me hope there is a hell.

The Good Ship This End Up

Remember a couple of weeks ago when we chose a name for the ship we here at Time Goes By are traveling together on my last great adventure in life? We voted, settling on This End Up.

Let me back up a bit. Last week one of my most favorite friends came to stay with me for a few days. Stan James, who is a blockchain engineer (you're on your own to figure out what that is), lives in Boulder, Colorado and he is one of the few people left in the world who often communicates by snailmail.

Postcards show up regularly along with the occasional actual letter on paper in an envelope. They always look something like this:


Yes, Stan is a master at beautiful, gorgeous, amazing calligraphy.

Somehow, until this trip, Stan had neglected to tell me that his art is not confined to paper. He is also what I am calling for now a beach calligrapher.

Here is Stan himself with one of his sand creations:


Since we are celebrating one of America' iconic holidays tomorrow, here is an appropriate creation from Stan for the season:

Happy Holidays

And now, the piece de resistance for the denizens of Time Goes By, take a look at this fantastic sand creation just for us:

Isn't that wonderful? It makes me want to cry with joy. You can find much more of Stan's sand calligraphy on his Instagram page.

Happy Thanksgiving, everyone.