Monday, June 3, 2013
After the End
Robert Cooper (Anchises) died on October 19, 2012 at 8:25pm. You may see his obituary on Legacy.com (direct link). As this blog is now finished, if you have any thoughts about Anchises, please leave them in the Legacy Guest Book.
Sunday, October 7, 2012
The End
It’s hard to believe that about a year ago, I was living a reasonably
normal life, walking briskly each morning in Prospect Park, that during the
year that followed, we ziplined in Alaska, floated down the Nile, still later
spent two weeks in Jerusalem where we saw our beloved friends, and that now, in
September 2012, I’m living under home hospice care, whose main purpose is to
improve my quality of life, which in my case is pain relief. Now that I’ve increased the dosage of my pain medication, I feel a great
deal better. I should point out to my readers that in order to be elegible for home bospice care, life expectancy is seen as less than six months .It's a relief not to spend half the week visiting doctors, when their ministrations can only be remedial.
I’d like to take this opportunity to thank my readers whose
encouragement has kept this blog running.
You know who you are.
Since I don't intend to write any more posts, this is the time to reveal my identity. I’m
Robert L. Cooper, who taught at the Hebrew University of Jerusalem for twenty
years, from 1972 through 1991. I began
as a Visiting Lecturer and ended as a Full Professor. My wife is Alice Pepper Cooper, my daughter is Lisa C. Philip, and my son is David P. Cooper. My daughter is married to Babu Philip, and Tobias (14) is their son. My son is married to Sharona C. Chalaf, and their children are Eylon (11), Mia (9), and Talia (6).
Friday, September 28, 2012
Body Image
Since losing 50 pounds in the late 1960s, I’ve been thin,
but I didn’t realize that slimness had become an important part of my
self-image. During my recent stay at
Memorial Sloan Kettering, so much liquid was pumped into me intravenously, that
I gained 25 or 30 pounds. It wouldn’t
be so bad if the extra weight had been more or less evenly distributed, but it
wasn’t. When I looked in the mirror I
was shocked to see that I looked like one of those Neolithic Venuses minus the
breasts – all stomach, hips, and thighs.
So when a nurse uncovered me, I would remark that I was
terribly swollen, as if to say, “no, I’m really not like that.” How ridiculous. The nurse didn’t care how I looked, but I
cared. This was the first intimation
that my body image was important to me. It’s
nice to learn new things, especially at my age.
Wednesday, September 26, 2012
Zytiga
Last Friday, I met my medical oncologist at Memorial Sloan
Kettering. He gave me both good news –
that Medicare has approved my use of a new drug, Zytiga (abiraterone) - and bad
news - that my cancer has spread to my
lymph glands. Neither news was unexpected. Medicare has begun to approve the drug, and
since the cancer had already spread to the urethra, the bones, the penis, a
lung, and the heart, it’s not surprising that it has continued its relentless
march through my body.
Prostate cancer is cunning.
The hormone I’m currently taking reduces the amount of the body’s
testosterone, which acts as a kind of fertilizer for cancer cells. So the cancer has begun to manufacture its
own testosterone. If the Zytiga works,
it will reduce further the amount of testosterone in the body. I’m too weak for chemotherapy, my doctor told
me, so the administration of Zytiga is the next line of defense.
A bulletin to which I subscribe published the final clinical data
for a trial of Zytiga. Those men who
took the drug showed an overall survival rate of 15.8 months whereas the
survival rate for those who took a placebo was 11.2 months. The difference of more than four months may
not seem like much until you compare those four months to being dead.
When my wife and I entered my oncologist’s office, my one
burning question was my life expectancy.
I didn’t ask, in the end, because it turned out I was afraid of the answer. But after reading that bulletin, I do have a
rough idea. Of course those statistics
are medians, with half the men above and half below. Still, the answer is a lot more favorable
than I had feared. If I’m lucky and if
I’m average, I’ll have more than another year.
Not so bad.
Monday, September 24, 2012
Quality of Life
Perhaps a year ago, I wrote about an elderly man who was
about to undergo a dangerous operation. Before
the operation, his daughter, a physician, asked him what quality of life
would be satisfactory to him if he were unable to speak for himself and the
question of resuscitation arose. As long
as he could watch football on television and eat chocolate ice cream, he told
her, he’d want to be resuscitated.
That wouldn’t be enough for me, I wrote at the time, even if
I made more congenial substitutions for chocolate ice cream and football. But while I was in the hospital, I changed my
mind. It would be enough for me, with
the important proviso that I was relatively pain free. Even in the hospital there was much to be
enjoyed – my visitors, the food, the television news, none of which required
more than what’s involved in eating ice cream and watching football. If I could read and write, so much the better,
but these activities, so important up to now, would not be a sine qua non.
There’s nothing like being faced with the alternative of
death to make you realize that even a life of limited scope can be worth
living.
Friday, September 21, 2012
Death Bed Scenes
“If your heart stops, do you want to be resuscitated, and if
you can’t breathe on your own, do you want to be intubated (a procedure in which a tube is
inserted down your throat and a machine takes over your breathing)?” Those weren’t their exact
words but that was the meaning of the questions that two young doctors were
asking me in the early hours of the morning towards the end of my first week at
Memorial Sloan Kettering Cancer Center.
I tried to explain that I didn’t want aggressive measures if they
brought me only a little more time at the expense of a severe reduction in my
quality of life.
I didn’t understand why they were asking me those questions
but later I learned that the oxygen level in my blood had dropped to a
dangerously low level and that my life was in danger. The doctors bid me good night and I was left
with my own thoughts. It suddenly struck
me that the two doctors would not have come to me late at night if death were
not an immediate possibility. I ought to
be reviewing my life, I thought, taking note of my successes and failures, my
hopes for my children and grandchildren, giving thanks for what had been a good
life. But no, I thought, I’m not up to
it. All I wanted was to luxuriate
in the warmth of my bed and in the freedom from pain which my
medicines had brought me. “Is this,” I
wondered, “what it’s like to die? If so,
it’s not so bad.”
I shouldn’t have done it but, feeling that the end might be near, I called my wife at three or four in the morning. I don’t remember what I told her but she came
to the hospital as soon as she could.
“I’m letting go,” I told her when she arrived. “It’s all right,” she said, “you’ve had a
good life and it’s okay to let go now.”
I fell asleep and when I awoke I felt a lot better. The drop in my
oxygen level, however, set in motion an effort to find the source of the
problem. A CT with contrast revealed a
tumor, surrounded by clots, that was traveling in a pulmonary vein into my
heart. My wife and daughter called our
immediate relatives, including our son in California, who dropped what they
were doing and came to see me. This gave
me an opportunity to tell each of them that I loved them and in one case to ask
for forgiveness. I consider myself lucky
to have had the opportunity to do so.
But I also felt a bit like a fraud, for by this time I was feeling
pretty good. “From now on,” I told
them, “you’re excused from further death
bed scenes with me.”
Wednesday, September 19, 2012
How the Old Man Got His Trunk
Down by the East River stands one of the world’s great
medical establishments, the Memorial Sloan Kettering Cancer Center. One day an elderly professor ventured inside
with what he thought was a minor complaint and didn’t leave for another 17
days. In the course of his treatment,
his blood oxygen level fell so low that he was given a high-speed oxygen
delivery system that included a beautiful blue-green plastic tube that was
placed over his face and reminded him of an elephant’s trunk.
“If Kipling were alive now,” he remarked to his night nurse
and his respiratory therapist, who were both attending him, “I’d ask him to
write a story about how the old man got his trunk.” The nurse and therapist looked at him
blankly. It was clear they had never
read or heard Kipling’s Just So Stories. So the old man told them how the elephant got
its trunk. The story charmed them, even
though he scarcely did it justice.
Curious, the old man asked his son, who had flown in from
California, and his daughter if they knew the story. They did not, even though the volume had been
in their library when they were children.
Perhaps their having grown up in Israel explains this gap in their
education, thought the old man. So he
asked another nurse and then another, but neither knew the story.
A crocodile did not create the old man's trunk nor was a crocodile responsible for its being taken away. The old man's breathing slowly improved and although his blue-green trunk was beautiful, he was not sorry to say goodbye to it. But he was sorry that the generations after him don't know what happened when a curious baby elephant, in the days before elephants had trunks, asked a crocodile, down by the great gray-green greasy Limpopo River, what he eats for dinner.
A crocodile did not create the old man's trunk nor was a crocodile responsible for its being taken away. The old man's breathing slowly improved and although his blue-green trunk was beautiful, he was not sorry to say goodbye to it. But he was sorry that the generations after him don't know what happened when a curious baby elephant, in the days before elephants had trunks, asked a crocodile, down by the great gray-green greasy Limpopo River, what he eats for dinner.
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