Friday, July 29, 2011

The Stream of Life

More than 50 years ago, when I was an assistant buyer at the late lamented Abraham & Straus department store in downtown Brooklyn, I lived not far away, in Brooklyn Heights. It was a summer day when I decided not to take the subway to work but to walk. In truth, the store wasn't very far from my apartment, no more than forty minutes by foot.My boss, a formidable man who inhabited my nightmares for years after I left the store, somehow learned that I had walked to work. He asked me why I hadn’t taken the subway, a trip of about ten minutes. I told him that it was so much more pleasant walking than descending into the depths of the earth, waiting on a hot platform, and then traveling in a crowded subway car. He was displeased. “Stay in the stream of life,” he said.

During my three terrorized years as his assistant, he taught me several valuable lessons, of which that was one, although its application to walking is, in my opinion, mistaken. The general principle is sound, however, and I thought of it recently when visiting old friends at their summer home in western Connecticut. Theirs is in a planned community whose houses are nestled among woods on a rustic preserve of 325 acres.

Our hostess drove us to the community’s office, so that we could send a fax in connection with the renovation of our apartment. At the office our hostess introduced us to another resident, an energetic woman of a certain age. I don’t remember how it was that we told her the fax we were sending was to solve a particularly frustrating problem in our renovation, but she responded, “You should build a house!” She built one in Florida, where she now lives most of the year, migrating to her home in western Connecticut only for the summer.

She had summered for years in our friends' community, but had spent the rest of the year in New York, before moving to Florida. “I never thought I would say this,” she told us, “but there are 40 reasons not to live in the northeast.” And then with the fervor of a religious convert she told us how good her life was in Florida. There are lots of things to do at the clubhouse, which seems to be the center of her life there; she can drive there from her home in just a few minutes; and she can wear practically nothing at all in the winter, while we in New York are bundled up like Eskimos.

To each his own, of course, but the idea of retiring to Florida appeals not at all to my wife and me. We want to be part of the life around us. At our age it would be hard to sink roots into the community at large if we moved away from New York. Our lives are here, where we began our married life, where our children, my wife, her parents, and grandparents were born, where the institutions with which we are long familiar are found, where our daughter and her family and many of our friends live. For the same reason that we hope never to move into “protected living” or worse yet into a nursing home, we would hate to live in Florida, isolated from the life around us. Even our neighbors in Brooklyn, mainly young families with children, give us a sense of being in the midst of life, as we interact with them and watch their children develop. How arid, in comparison, would be a life centered around a clubhouse, frequented almost exclusively by other retirees.

True, New York winters are hard, especially for the elderly, but there’s a sense of accomplishment and pride in withstanding the worst that the snow, sleet, and cold can bring. And for our perseverance, the glories of spring, summer, and autumn reward us. This progression of seasons, a progression that reminds us of the cycle of life, is sadly lacking in Florida.

"Stay in the stream of life,” said my boss, and he was right.



© 2010-2011 Anchises - An Old Man's Journal All rights reserved.

Wednesday, July 27, 2011

Room Eight

Last Friday, when it reached 104 degrees in Central Park, I entered the cool reception hall of the Kimmel Urology Center at Memorial Sloan Kettering Hospital. The Center is new, the furnishings modern and expensive, and if you weren’t paying attention, you might think that you’d walked by mistake into the lobby of a boutique luxury hotel.

My mission that day was to receive an injection of Lupron, a drug that suppresses the production of testosterone, a hormone that promotes the proliferation of prostate cells. When I announced my presence to the young man at the desk, he told me to go to Room Eight, which caused a bit of confusion inasmuch as I had no idea of the room’s location. “Is this your first time?” he asked. When assured that it was, he led me through a door marked “chemotherapy” and brought me to a cubicle with a large, comfortable leather chair, some smaller chairs next to it, and a television set that was tuned to a show hosted by Whoopi Goldberg.

A pretty blonde nurse named Anna entered and asked me, in a vaguely Slavic accent, if I had experienced various symptoms (breathless? fatigued? blood in the urine?), most of which I was happy to say were not present. She explained the possible side effects of the hormone therapy, the least unpleasant of which are hot flashes, enumerated those symptoms that should merit a call to my doctor, drew the cubicle's curtain shut, told me to drop my trousers, asked me if I had a preferred buttock (no), then punctured the side closest to where she was standing. I understand that within a few weeks the injection should allow me to walk without pain. I hope soon to be able to hang up my cane and stride once again along Prospect Park paths.

Confused as to the location of the exit after leaving Room Eight, I wandered about for a minute or so before sighting my nurse and asking her for directions. That minute gave me enough time to glimpse at least a half dozen patients sitting in large leather chairs like the one I had vacated, each in his or her own cubicle just like mine, each attached to an IV that presumably was delivering a chemotherapy drug. I hope they were an unrepresentative sample, for they looked pretty ill, each sunk in a private reverie, despite the presence, in most cases, of another person, probably a family member, occupying one of the smaller chairs in the cubicle.

No doubt the injections are given in the chemotherapy section for convenience. After all, nurses are required for both treatments. But I couldn't help wonder if perhaps there was another reason. Perhaps it was to warn us that the feeling of regained health, which the injections provide, will be temporary, and that in the end, after the inevitable failure of the hormone treatment to halt the proliferation of cancer cells, we too will be attached from time to time to an IV line.

That there’s another stage of defense down the road is encouraging, since it suggests the possibility of greater longevity, but the appearance of those haggard patients was a downer. All the more reason, I thought, to seize the moment while I’m still vertical and reasonably ambulatory. This would take the immediate form of a raspberry sorbet should I pass an ice cream establishment on my way home. Alas one was not to be found, but on the way, I bought six yellow carnations, a treat less fattening and likely to last a lot longer.


2o10-2011 Anchises-an Old Mans Journal. All rights reserved.



Monday, July 25, 2011

Onwards and Upwards

In Friday’s blog post I wrote that I’d like to visit the Egyptian and Mexican pyramids and sail down the Nile. But then I awoke before dawn with second thoughts. I wondered if I'm nuts. I’d be 80 years old when embarking on these excursions. Both in Mexico and Egypt, I’d be far from metropolitan centers much of the time. What if my illness became acute? Doesn’t my present stage of development preclude more globe-trotting? Isn’t that part of my life over? Shouldn’t it be over? You know how it is at four in the morning.

But later that day, fully awake, I read about an 81-year-old widow who spends ten months a year traveling to exotic locations. She travels light, with only one pair of shoes, the barest minimum of clothing, and miniature cars to give to children en route. She’s not letting her age stand in her way of living the way she wants.

Neither is Diana Nyad. Last Tuesday, the Times reported on her mission to swim from Cuba to Key West. A long-distance swimmer, she’s swum from Bimini in the Bahamas to Jupiter, Florida, a distance of 102 miles. But a year before that, in 1978, she was forced to abandon her attempt to swim the 103-mile route from Cuba to Key West after swimming 50 miles, when tumultuous seas pushed her far off course. Now, at the age of 61, she’s trying again. She’s trained for a year and a half, enlisted a support team of 22 people, and has raised most of the half million dollars required for the venture. She hopes her exploit will help people say “‘I want to live life like that at this age.’ I want the candle to burn bright.”

I too want the candle to burn bright. I couldn’t engage in long-distance swimming at any age, but there are more candles to burn than one. At 60 I traveled around the world by surface transportation, by means of ferries, railroads, freighters, and automobiles, never once boarding an airplane. This was pretty tame compared to swimming in the ocean for 103 miles without a shark cage, but for me it was what Ms. Nyad, the marathon swimmer, calls “energizing.” During that journey I felt fully alive, completely immersed in the moment, a feeling I'd like to capture again.

The examples of these two women, one 81 the other 61, made me laugh at my fears about setting forth again at 80 on what after all would not be a very hazardous or adventurous journey. So the other day, after discussing the matter with my wife, we signed up for a two-week educational tour of Egypt, a Road Scholar (formerly Elder Hostel) program. This will include, of course, visits to the pyramids and a cruise down the Nile, covering two of the items on my wish list. We’re scheduled to fly to Cairo a few days after my 80th birthday. Onwards and upwards.



© 2010-2011 Anchises-an Old Mans Journal All rights reserved.

Friday, July 22, 2011

Wish List

On the front page of the Weekend Arts section of last Friday’s Times appeared an article with the headline “A Single Pleasure Ere Summer Fades.” So often, the author writes, we let the summer slip away without managing to do anything for our own pleasure – reading that book we meant to read, for example, or seeing that film we wanted to see.

That opening paragraph made me feel rather pleased with myself because I had done at least two of the things I had meant to do for my own pleasure this summer. I had visited the Cone Sisters' exhibit at the Jewish Museum, which presents a judicious sampling from their fabulous art collections, on loan from the Baltimore Museum of Art, and I had seen Woody Allen’s latest film, Midnight in Paris, a delightful jeu d’esprit and a love letter to Paris. But since it’s unbecoming to be pleased with oneself, I soon turned my thoughts to the more serious issue of not letting the rest of my life slip by without doing a few more thing for my own pleasure.

If I were a serious person, I would find pleasure in writing another book, volunteering at a local hospital, or otherwise contributing to the general welfare, miniscule as my contribution might be. I used to be a serious person, but I figure that at my stage of development I’m entitled to seek pleasure where pleasure is to be found.

Would I find pleasure in learning Spanish, so that I could eavesdrop on conversations in the subway? Indeed, I would be pleased to know Spanish but not so pleased to work at acquiring it. What about renewing my knowledge of French, which was kicked in the head when I learned Hebrew? Then I could read Remembrance of Things Past in the original. It’s clear I’m a deeply unserious person to propose something so unlikely. I’m reminded of Johnson’s remark about whether some object was worth seeing. Yes, it was worth seeing, he said, but not worth going to see. Self-improvement is not going to get very far with me, I’m afraid.

So here’s a more realistic list of things I’d like to do for my own pleasure in the time that’s left to me. I’d like to see the pyramids, not only those in Egypt but also those in Mexico and Central America. And while I’m at it, I’d like to take one of those four-day cruises down the Nile, stopping along the way to view antiquities. This is, admittedly, a self-indulgent list and if I never manage to check off any of them, I won’t feel terribly deprived. After all, I’ve already walked on the Great Wall of China, viewed the Taj Mahal by moonlight, and watched, from the deck of a slow boat to China, the sunrise over the Pacific.

Exotic travel is all very well and good, but what I most want is domestic. I’d like to bring both my children’s families together for a visit. Our son and his family live in Los Angeles, whereas our daughter and her family live in Brooklyn. The logistical issues in bringing them together are formidable. But when these issues are resolved, our children's and grandchildren's reunion gives me the most pleasure of all. When they are together, I can kvell in the presence of my descendants and once again act as pater familias. That I have combined Yiddish and Latin in one sentence testifies to the strength of my emotion.

So that’s what I hope won’t slip away in the years (I hope) ahead of me. In the meantime, I’ll see more films, visit museums more often, lean something new, and meet my friends for lunch.


(c) 2010-2011 Anchises-an old mans journal All rights reserved.


Wednesday, July 20, 2011

Transformation

My medical oncologist was a little boy the first time we met him, when he visited us in Jerusalem with his parents, good friends of ours, and his older brother. I couldn’t know, of course, that roughly forty years later I would be hanging on this child’s every word. My wife and I met him again last Friday at the Sidney Kimmel Center for Prostate and Urologic Cancers at Memorial Sloan Kettering Hospital, where he is engaged in research concerning prostate cancer metastases to the bone and to the lymph nodes.

Now a distinguished medical researcher, the former little boy is a man of medium height, trim physique, and a neat beard, who displays both intensity of focus and warmth of personality. He explained the nature of my disease and the treatments available, impressing us by his knowledge, his ability to convey clearly what we needed to know, and his compassion. During his physical examination, he revealed what’s been called a “healing touch,” hard to define but easy to recognize. I'm in the best possible hands.

He transformed my understanding of my disease. Instead of looking at my metastasis as a fatal disease whose progress can be slowed, he views it as a chronic disease, like hypertension and COPD, that can be managed. Since a man my age has a pretty limited life expectancy in any case, the two views may amount to the same thing, but his way of looking at my disease is, of course, much more attractive. So I will have to give up the romantic view of myself as suffering from an incurable, fatal disease and return to the ranks of ordinary mortals. It’s a move I’m happy to make.



(c) 2010-2011 Anchises - an old man's journal All rights reserved.

Monday, July 18, 2011

Identities

In a class led by Rabbi Andrew Bachman, of Congregation Beth Elohim, we studied a letter from Moses ben Maimon (1125-1204) to Rabbi Obadia, a convert to Judaism. Rabbi Obadia had asked if his status as a convert excluded him from those prayers and blessings that alluded to the Jews’ common ancestry. Was he permitted to say, for example, “God of our fathers,” or “You who have brought us out of the land of Egypt?”

Moses ben Maimon, medieval philosopher and physician, also known as Maimonides, was one of the greatest rabbinical scholars in Jewish history. Thus his answer to Rabbi Obadia carries great weight. Ben Maimon responded that Rabbi Obadia could say all the prayers and blessings without changing them in the least. This is because Abraham converted many people, bringing them “under the wings of the divine presence.” Just as he converted his contemporaries, so all future converts are considered the disciples and thus the children of Abraham, who was the ancestor of Obadia no less than of Maimonides himself.

Obadia’s question concerned a topic that had been much on my mind. I'd been thinking about my own identity in part because I had recently reviewed a volume of essays about language and ethnic identity and in part because in the evening of my life, having known five generations of my family, I increasingly see myself as a link between the future and the past.

Jews’ common ancestry may be a myth, but if so it is a most powerful one. I consider myself a Jew by virtue of birth, whether or not my ancestors ever lived in Palestine. For all I know, they could have converted to Judaism in, say, the 18th century. But it doesn’t matter. Even though there’s no historical evidence for the existence of the Biblical patriarchs and matriarchs, even though Genesis and Exodus may be literary creations rather than historical accounts, I descend, in an admittedly mystical fashion, from Abraham, just as did Maimonides and Obadia. Judaism is, in other words, not only a religion. It is also an ethnicity, a collective defined by belief in a common ancestry.

Of my many identities, some are no longer active. My identity as a student is unlikely to be revived and my identity as a soldier cannot. My identities as university professor and academic researcher have long been in mothballs, unlikely to be taken out for an airing. My identity as an Israeli, now that I’m back in the United States, has become almost vestigial, although I retain a lively interest in the news from Israel. Whereas my Israeli identity has weakened here, my American identity never lessened during our 36 years in Israel.

It turns out that my identities as an American and as a Jew, both acquired at birth, are the ones that have lasted the longest. Of the two, my Jewish identity is the stronger. In part this is the consequence of encountering Antisemitism in school, but that ‘s not the most important reason. My Jewish identity seems primordial, imbibed with my mother’s milk, whereas my American identity does not. I could have been born anywhere, but as the child of my parents, I’d be a Jew, whether or not I ever observed any of the religion’s rituals or commandments.

Even so, my Jewish ancestry began at the earliest during the second millennium before the Common Era, whereas the bulk of my ancestors, like everyone else’s, lived for innumerable generations before that. If we go back far enough, to the divergence of homo sapiens from other hominids about two and half million years ago, everyone on earth is probably related to everyone else. Thus, it’s curious that such a slight sliver of time, the generations since Abraham, should have had such a powerful impact. And it's remarkable that even if Abraham, Isaac, and Jacob, along with the Books of Genesis and Exodus, should be fictional, it doesn't matter at all.



(c) 2010-2011 Anchises-an old man's journal All rights reserved.


Friday, July 15, 2011

Saying Goodbye

Unlike my unfortunate mother, who died at the age of 47, before any of her children had left home, my father had the pleasure of seeing each of us marry, establish homes, and begin to raise children. With the important exception of the last six months of his life, when he lived in my brother’s guest cottage, my siblings and I lived far from him during most of our married lives. Whereas he lived in a suburb of Boston, my brother and his family lived near Kingston, my sister and her family lived near Utica, and I and my family lived all over the place – New York, Addis Ababa, Palo Alto, San Diego, and finally Jerusalem. My father would visit each of his children and we would visit him, but these visits were generally brief, since my father, who worked almost until the end of his life, didn't like to take long vacations. Most of the time, we communicated by phone and by letter, mainly his letters. For years he wrote to us once a week, often enclosing a check for a birthday, an anniversary, or for no reason at all.

Each time I saw my father after an absence, I was struck by how much older he looked, so different from the mental image I carried of him. While it was hard to see his gradual decline, it was much harder to say goodbye to him at the conclusion of each visit. One time, when he was visiting us in Jerusalem, he worried that he might miss his return flight to Boston if he didn’t spend the night in Tel Aviv. So on his last evening in Israel, I drove him to a hotel there, where, in the lobby, I hugged him goodbye. As I did so, I wondered, as I always did during those last years, if I would ever see him again. He entered an elevator, its door closed, and I turned to leave. As I did so, a hotel clerk, who had witnessed our farewell, said “It’s hard to say goodbye to a father.”

It’s hard to say goodbye to a father, but, as I’ve since learned, it’s hard to say goodbye to a child. We have the privilege of living close to our daughter and her family, who in fact live in the other wing of our apartment house in Brooklyn, but our son and his family live in Los Angeles. We see our Los Angeles family only a few times a year – generally twice a year and with luck three times, never for longer than a week or two per visit. This summer, as she’s done for the past ten years, our daughter-in-law took her children to visit her parents in Rehovot, Israel, where they will spend six weeks. Our son will join them for the last few weeks of their stay. After they had left for Israel but before he joined them, he flew out from Los Angeles to spend a long weekend with us.

It was a lazy four days that he spent with us, a time of snoozing and shmoozing during the intervals in which he was not negotiating various business deals via the medium of his Blackberry and laptop computer. His visit gave us great pleasure even as his departure, as we knew it would, gave us some pain. As I hugged him goodbye and watched him enter the town car that would take him to the airport, I wondered if I would see him again. I used to wonder if my father would still be alive when it was time for the next visit. Now I wonder if I will. Only now do I realize that my father probably had the same thought when he said goodbye to me that evening in Tel Aviv.

Wednesday, July 13, 2011

Looking Sharp

The other day my wife and I ventured into the depths of Brooklyn to choose the backsplash for our renovated kitchen. This was not an errand that demanded much in the way of sartorial elegance, but I like to look my best, so I dressed up. Old people like me are often ignored, looked through as if we aren’t there. But when I dress my best I feel at least seen. So I wore a blue seersucker jacket, a light blue oxford cloth button-down shirt, a silk bow tie with small red and white stripes, a darker red silk square, dress chino pants, and a blue cloth brimmed hat with a red and blue band.

On the MTA platform at our destination, I encountered three burly workmen, each of whom could have bench pressed twice my weight. “Hey, Buddy, you’re lookin’ pretty sharp,” one of them said as I approached. “You look great.” I thanked him. As I descended the stairs on the way to the street, one of them called out to me, “When you dress like that, you can get hot girls to go out with you.” Since my wife was right ahead of me, I called back, “I’m already doing it.” This got a big laugh.

The whole interaction pleased me. But when I thought about it I realized that had I been 20 years younger, the interaction never would have occurred. Were these workmen, then, patronizing me? I don't think so. In fact the opposite may have been the case. The workman who called me "Buddy" instead of "Sir" or "Mister" or nothing at all was saying in effect that the two of us were equal, that we were playing on the same field, that the status distinctions between the two of us either did not exist or were irrelevant. I suspect that old age mitigates status differences. It would be fun to design a study that tests this hypothesis. In the meantime, I'm happy to accept a compliment wherever I get one.

Monday, July 11, 2011

Cadavers

One of the attractions in Paris of the 1830’s, I learned recently from David McCullough’s superb The Greater Journey: Americans in Paris, was the Paris Morgue, on the Ile-de-la-Cité, where unidentified bodies taken from the Seine – mostly suicides but a few murder victims too - were laid out on black marble tables. If no one claimed a body after three days, it was sold to a medical doctor for ten francs.

McCullough doesn’t tell us if there were enough drowned corpses to supply the École de Médecine faculty ’s demand for cadavers. The demand was great because dissection had become a sine qua non for medical education. If the supply of corpses from the Seine was inadequate, as is likely, the medical faculty in Paris probably turned to an expedient common throughout the western world, namely grave robbing. “Resurrectionists” would dig up freshly buried bodies – the earth had not yet settled, which made it easier to exhume the corpses, and the bodies would not yet have decomposed – and sell them to medical schools.

Harvard Medical School, established in Cambridge in 1792, moved to Boston in 1810. According to the school, Boston “was more convenient for the faculty to see not only their private patients, but also patients in the military and naval hospitals and in public dispensaries being established in the city.” According to other accounts, however, there was an additional reason. It was easier to obtain corpses in Boston than in Cambridge.

Thoughts of graves and corpses occupied me few weeks ago during a recent hour and half stint in an MRI cylinder, where various parts of my anatomy were being scanned. Lying flat on my back and wearing earplugs, I was slowly slid inside the cylinder. There I was entertained by a series of very loud sounds - some short staccato bursts, others long blasts, one set of which sounded eerily like the opening bars of Die Meistersinger. When I was not following the technician’s instructions to take a deep breath and hold it, I could not help thinking that the capsule in which I was entombed was very like a coffin. It was a comfortable coffin to be sure, with ventilation and soft lighting, but it was like a coffin nonetheless. And that reminded me of the body snatchers employed by medical schools in the 18th and 19th centuries.

Lying inside a coffin-like container is not an experience I long to repeat any time soon. I comforted myself during that ordeal by two thoughts. First, I would soon be released from my entombment. Second, I won’t be buried in a coffin, at least I’m pretty sure I won’t. I’ve left instructions – a request, really, because my instructions will have no legal standing after I'm dead - that my body be donated to a medical school for dissection. When the dissection is complete, my remains will be cremated.

Medical schools no longer depend on grave robbers for cadavers but on those who, as obituaries note, “leave their body to science.” I thought of all this between staccato bursts and the strains of Die Meistersinger. I suppose I should have tried to think of something less morbid, but I found it hard to escape the influence of my immediate environment. Still, these meanderings were not entirely morbid, for the thought that my body will help to educate a doctor, that it will be of use, is a comforting one. Nonetheless, I’m not eager to provide the means for that education any time soon.

Friday, July 8, 2011

Slowing Time

When I was younger, time stretched out before me, and the time left to me seemed indefinitely long. Now the time left to me seems indefinitely short. According to the U. S. Bureau of the Census’s Statistical Abstract for 2011, the number of years remaining to the average 80-year-old white male in 2007 was 6.7. The invasion of my bones by prostate cancer makes that figure pretty optimistic in my case. “Depend upon it sir,” Boswell quoted Johnson as saying, “when a man knows he is to be hanged in a fortnight, it concentrates his mind wonderfully.”

My mind is concentrated for sure, but I need not be gloomy. First of all, I've already lived far longer than the average white American male born in 1931. According to the Statistical Abstract, a white American male born as late as 1970 had a life expectancy of only 68. One way to look at it is that I’m living on borrowed time. But I prefer to think of these added years as an entirely undeserved bonus.

Second, and perhaps more important for my present state of mind is the notion that by cultivating awareness, I can slow time down, so that the time left to me can seem much longer and richer than the same amount of time when I was younger. This idea was strengthened recently when I listened to Krista Tippett’s radio interview with the neuroscientist Richard Davidson. A professor of psychology and psychiatry at the University of Wisconsin, Davidson is best known for his brain studies of contemplative Buddhist monks, which he pursued in cooperation with His Holiness the Dalai Lama. The interview can be heard at www. on being.org.

When Ms. Tippett asked Professor Davidson how his understanding of being human had changed since the 1960s and 1970s, he said that he now has a richer, more encompassing sense of what it means to be human and that he has a greater appreciation for the preciousness of each human encounter. Further, he said that in many respects he has a subjective sense of time slowing down, because he is now better able to stop and look at each moment in order to appreciate what it might offer instead of rushing off to the next thing.

So often the people I see on the street look as if they’re dashing grimly to their next appointment, their next task, rushing through life without savoring it at all. Perhaps New Yorkers are more prone to this headlong behavior than residents of other cities. As early as the 1830s, New York merchants were described as walking as if a good dinner were before them and a bailiff behind. And businessmen’s lunches were described as being hurriedly eaten, almost wolfed down. This seems such a pity when there’s so much to notice, so much to appreciate in life.

A listener asked Professor Davidson how being present applied to multitasking. First of all, he said, there’s a question as to whether a person is really doing two things at once or oscillating rapidly between one task and another. But in either case, the aim is to pay attention to whatever it is you are doing, to live in the moment, without thinking of your next appointment, your next deadline, the next thing on your list of tasks.

If I think of the time ahead as composed of innumerable moments, opportunities to look about and appreciate what there is to be seen - the thin red streaks on the petals of the yellow carnations on our window sill, for example - my remaining life will, I think, be enriched and not seem so short. Since Professor Davidson supports me in this expectation, I will do my best to cultivate awareness, to appreciate the world around me, and to savor each moment as it comes.

Wednesday, July 6, 2011

Courage

When I tell you about my latest act of courage, you’ll probably scratch your heads and say, “he found that hard to do?” But if you consider some of the things for which I’ve had to screw up my courage, you’ll see that this current bit of bravery is entirely consistent with what I've found found hard to do in the past.

In an earlier post, I wrote about breaking the leg of a schoolmate. I was in the fourth grade, new to the school, and, during recess, I sat on a hill and watched a softball game below. It was a stupid thing to do, but I did it anyway: I kicked a stone, which rolled down the hill and broke the leg of the batter. My mother forced me to call up that boy and apologize. This was the first test of courage that I can recall. “Just wait until I get out,” the boy said, “I’ll get you then.” It would please me to report that I said, “Just try and I’ll break your other leg,” but if I found apologizing to him hard, I would have found threatening him even harder.

When I was competing for a position on our college newspaper, I was assigned to interview, during his visit to our university, the president of Keio University, the oldest institute of higher learning in Japan. I was ushered into the office of our university president, where an ancient man sat behind a large desk. The splendor of the office and the distinction of the visitor awed me almost to the point of catatonia. Nonetheless, I managed to stammer some inane questions, which the old man courteously answered. Had I had my wits about me I would have asked him about the effects of the recently concluded war on his university (for my generation, “the war” refers to the second world war), but that I managed to ask him anything at all served as a minor triumph of bravery.

After I earned my Ph.D. I screwed up my courage to call my dissertation advisor by his first name. He was only five years older than I was, but I held him in such awe that it was hard for me to do. It was almost as hard as if I had tried to address Queen Elizabeth as “Liz” or the pope by his first name.

At the Hebrew University of Jerusalem, instructors from abroad are expected to lecture in Hebrew after the first three years of their appointment. Giving my first lecture in Hebrew required great courage since a generous estimate of my vocabulary then was about 2,500 words. I had rehearsed my lecture with a teacher and had penciled in her numerous corrections, but even so, the sweat rolled down my cheeks as I delivered my talk. As I spoke, I felt as if I had jumped off the Brooklyn Bridge and was trying to fly towards the Manhattan Bridge by waving my arms in the air as hard as I could. While you might think it was hard for the students to listen to me struggle, the truth is that they preferred to hear execrable Hebrew than beautiful English. Even so, that first lecture in Hebrew was one of the hardest things I’ve ever had to do.

After several years of working with a doctoral student, it became clear to me that I had made a mistake in accepting her as a candidate. She would never earn her doctorate unless I wrote her dissertation myself. I had put off informing her of my decision as long as I could, but finally I managed to tell her that I was no longer willing to work with her. She was wasting her time and mine. This was hard for me to do because I knew it would be a devastating blow to her, and I didn't want to hurt her. It did hurt her and I felt terrible. Even now I wonder if I should have let her continue, even though I knew it would be in vain.

With this as background, I will tell you my latest act of courage: I called a doctor’s office to ask for an appointment. I’ve had many operations over the years and not once did I even ask for a second opinion about the course of treatment. But now that I’m faced with a disease that cannot be cured, only slowed down, I wanted to put myself under the care of a doctor at Memorial Sloan Kettering who specializes in my problem – prostate cancer’s metastasis to the bone. That meant leaving the urologist who had supervised my treatment for prostate cancer since 2007, a man recommended by my primary care doctor, whom I greatly respect. Why did I find it so hard to call the oncologist? Because I was afraid of hurting my urologist’s feelings. I knew this was ridiculous, but even so I probably would not have called him had not his father, an old friend, urged me to put myself under his son's care. I knew he was right, and I did what he advised me to do. Nonetheless I found the task difficult.

This list of brave acts is not very impressive, I admit. None of them, after all, was like landing on Guadalcanal Beach. None of them required me to do more than to speak. Still, from the sixth grade on, saying what I felt to be the right thing has sometimes been the hardest thing for me to do. Miss March, the principal of my primary school, was right when she said at our final assembly, “boys and girls, the way you are now is the way you’ll always be.” The boy was indeed the father of the man. And that man had to screw up his courage simply to call the office of a specialist who is superbly qualified to care for him. Go figure. But I did it.

Monday, July 4, 2011

After Running in the Air

We all know the cartoon character that runs off a cliff and keeps running in the air until he looks down and realizes that there’s no ground under his feet. Then he plummets to earth. He always survives these setbacks, however, and goes on to other adventures.

Like the character running in the air, those who’ve experienced a life-altering event sometimes need time before their situation sinks in. Women who’ve been raped sometimes fail to report the crime immediately because in their shock they fail to realize the gravity of what’s happened to them. The Rutgers student whose tryst with another man had been shown on the web committed suicide only several days after this violation of his privacy.

My wife and I were running in the air for the first few days after my doctor told me that my prostate cancer had metastasized to my bones. We continued with our ordinary tasks, we went to the movies, we saw friends. But by the third day, the gravity of the diagnosis sunk in, and for both of us the world no longer looked the same.

Ever since seeing the revival of Our Town last summer, when I heard Emily Webb ask the Stage Manager if anyone really appreciates the value of being alive, appreciates "every, every minute," I've been writing about the brevity of life for a man my age and the importance of experiencing to the fullest the time that is left. I meant what I wrote, but it was all a bit academic to me. I didn't feel what I was saying as deeply as I do now, when the days that are left are much more limited than I had supposed and the end game likely to more painful and debilitating than I had imagined.

So this is my last chance to be shot by a jealous husband, for soon I’ll be taking a drug that suppresses the manufacture of testosterone, along with my libido. But let’s just say I’m shot by a jealous husband right now. And when I descend to the afterworld, I’m told that the jealous husband had mistaken me for someone else and that for once justice will reign in the world. I will be sent back to Earth to live a few more years. Were that to happen, I would be thrilled. I would look at each day as a gift. I would value each day. I would appreciate “every, every minute.”

Now that I've stopped running in the air, that's how I look at my life.

Friday, July 1, 2011

Disgusting Enough

During a hot afternoon about 15 years ago, my wife and I passed a soft ice cream store. In the words of one of Helen Hokinson's imperishable matrons, I said “let’s just walk in and see what happens.” What happened were two bowls of soft vanilla ice cream nestled in pools of caramel sauce. We took the sundaes outside to eat at a rustic table. I’m never much good at prolonging a pleasure, so I had finished my sundae when my wife had consumed about half of hers. When finally she did finish, she said somewhat unhappily, “not disgusting enough!” She meant, I found out, that there had been enough caramel sauce for the ice cream but only just enough. There had been no caramel sauce left over to spoon up by itself.

I thought of that incident recently after I finished eating French toast at Café Europa, on the corner of 57th Street and Seventh Avenue in Manhattan, across the street from the office of my primary care physician. The toast, dusted with confectioner’s sugar and decorated with a sprig of mint, arrived with a small pitcher of maple syrup and two pats of butter. I slathered the toast with butter and maple syrup and when I finished eating the toast, half the butter remained as well as several spoonfuls of maple syrup. The treat was absolutely disgusting enough.

Normally when I go to Café Europa, I order something sensible, like a salad niçoise, so my order of French toast reflected an event out of the ordinary. My doctor had just delivered some bad news, which I could tell pained him to tell me. A recent MRI had shown that my prostate cancer had invaded my bones. That’s why my hip hurts. That’s why I’ve been using a cane.

What I need, I told myself, when I entered the Café Europa after receiving this news, was a stiff drink, preferably a double scotch. But it was still a bit before noon, the café served only wine, and I knew that more than a thimble full of alcohol would play havoc with my digestion. The momentary buzz would not be worth the subsequent, relentless heartburn, so I settled for the French toast with butter and maple syrup. How have the mighty fallen.

The usual first treatment for bone metastasis from prostate cancer, I learned from a search on the web, is the suppression of testosterone, a hormone that acts as a kind of fertilizer for prostate cells. Hormone treatment can stop the metastasis for as much as two years. (My wife tells me that when I received this treatment a few years ago, after my cancer was first found, I became very agreeable, so she can look forward to my being a nicer person at least for awhile.) When the hormone treatment no longer stops the proliferation of prostate cells, various drugs are then employed. Many of these have recently been approved by the FDA and, according to a recent article in the infallible New York Times, the use of several of these in succession can prolong a man’s life for another two years. So, folks, I’m not ready to stop flossing my teeth.

“Life admits not of delays,” said Samuel Johnson, “when pleasure can be had, it is fit to catch it. Every hour takes away part of the things that please us, and perhaps part of our disposition to be pleased.” I’m still in a disposition to be pleased, hence the satisfactorily disgusting French toast with butter and maple syrup.