Chapter Two

Dear Friends,

Chapter Two…

…….…prior to which our Narrator…
1. …received cautious news that his colon cancer was “in remission”. Hearing this…
2. …he was unaccountably reluctant to share the news or blog about it; when…
3. …shortly (3-4 months later) during a carefully aggressive monitoring using CT scans and followup PET scans, doctors discovered that two marble-sized colon cancer tumors had lodged and grown rapidly in the nourishing environment of his liver, far from easy access to surgical excision; in response to which…
4. …able surgeons, stubbornly immune to mere logistical difficulties, responded with rapid alacrity and admitted our Narrator—almost immediately after discovery of the tumors (and just before Christmas)—to the hospital, to undergo a long and complicated liver resection operation to remove the tumors; in response to which…
5. …Monica and I await our oncologist’s recommendations about next steps; and…
6. …we continue, prayerfully, to stumble into the unknown future.

Detail

I don’t have the necessary medical training to possess easy command of the proper terminology and vocabulary, but… following are a few of the most important things I believe we are, today, understanding about cancer:

Genesis

Microbiologists now understand that specific cancers (there are many different kinds, each with their individual characteristics) have insinuated themselves into the fundamental genetic construct of our DNA. It is quite possible that the initial insinuation into our human genome took place thousands of generations ago. If this is correct, then cancer (which Siddartha Mukerjee defined in his admirable and thorough recent “biography” of cancer as “The Emperor of all Maladies” has, perhaps, co-existed with us humans for millennia. This evokes a very different awareness of Pogo’s “We have met the enemy, and he is us.” The various cultural metaphors that claim that both good and bad resides in each human being are also thus vindicated in the physical biological realm and put in shocking high relief.

Action

Oncologists have long studied the behavior of cancer cells and their unbridled growth. Cancer cells exhibit a unique attribute in that, once stimulated into activity, they appear to lose a normal cell’s inborn mechanism eventually “to die” and cease activity. It is as if cancer cells have discovered a way to achieve a kind of immortality. Indeed, cell biologists, today, study cancer cells in their laboratories that have directly descended from cells originally taken from one woman, a patient who, herself, died, now, decades ago! Certain chemotherapies exploit this constant and rapid replication by targeting rapid cellular growth as loci at which to deliver toxic chemical substances designed to kill the cells. Refinements are continually sought to distinguish the rapid replication of dangerous cancer cells from the rapid generation of beneficially evolving cells like hair follicles or digestive wall membranes.

Apart from the incontrovertible biological evidence about the workings of cancer cells, there are cultural echoes, again, principally in mythology, cautioning against the lure of the “fountain of youth” or describing the unintended consequences of Midas’ touch.

  Pathways

A focus of increasing attention for epidemiologists are the biological/cellular pathways through which cancer cells appear to communicate with one another to “stimulate” (one might be inclined to use the word “infect”) other cells. In my case, for example, it came as no surprise to my medical professional care-givers that my colon cancer reappeared, next, in my liver. There exists ample convincing evidence that this is one of the preferred evolutionary pathways colon cancer, particularly, exploits. Just what mechanisms enliven the pathways or stimulate the transmission of cancerous activity at one spot in the body to another are not yet known. The identified preferred pathways exist, at least, as promising targets for future research and therapies.

Stimulants

Finally, biologists are beginning to identify what substances, chemicals, infinitesimal elements can stimulate dormant cancer cells to “life”. These stimulants are more properly known as carcinogens. While the list of known carcinogens is growing (cigarette smoke, second-hand smoke, asbestos particles, certain petrochemicals, soot, some foods, etc.) precisely how they evoke a response in cells that appear to lie in wait in all human beings, why in some and not in others, in what concentrations or under what circumstances, is all rich ground for the minting of future MD’s and PhD’s.

So, for the time being, I will be subject to, perhaps crude, certainly experiential, therapies and remedies that will be prescribed by young doctors and clinicians who wish to find the proper therapies as much as I wish for them to do so. I cannot compete with their sophisticated understanding of what I’ve crudely outlined above, even though I can, perhaps, grow in my appreciation of what scientists have come to understand and how dreadfully complicated is what is not yet known. Be that as it may, I am confident and happy to turn over the care of my medical condition to the experts who have generously eked out a career in this forbidding territory.

What I may be better able to learn from, for my own well-being, if not specifically my body’s, is to examine the cultural and spiritual echoes that seem to resonate and whisper with each scientific discovery.

We’ll see… in future cancerblogs.

Chet

Courtesy and Blessings

Dear Friends,

Summary

I was well-taught by my mother in the precepts of courtesy. This is why, until today, I have felt increasingly guilty.

Details

Monica and I have been receiving very encouraging and important-to-my-well-being, notes, cards, e-mails, letters and phone calls expressing wishes for my health and inquiring about our progress in addressing the cancer that is so much a part of our attention lately.

    A family experience

I am particularly grateful for those notes that recognize that it is Monica and our children—far more than I, alone—who bear the weight of this disease. While I, as “the patient”, must contend with the physical, emotional and real consequences of being ill, my family and other loved-ones experience the same illness in ways that can always trump my personal challenges. It is because they possess the curiously human quality of “empathy”.  Empathy, which is a “sharing in” or “living with” another person’s experience, seems inevitably to do so with a heightened intensity. In the case of illness, with greater regret, greater sensitivity, greater anger and greater objectivity… therefore, with greater experienced sorrow. Those messages that succeed in recognizing this reality are particularly appreciated. They reflect an understanding of how an illness can affect the dynamics within any family, and particularly within our family. They help me articulate an awareness that my illness is not, and can not be, in any sense, solitary or isolated. They help me realize I cannot be selfish about these received communications of encouragement that so assists me in dealing with my cancer. Properly speaking, each of these messages assist every one of us, Gryczes, in dealing with our collectively experienced cancer.

    Creativity

Several notes contain creative ways for friends to provide day-to-day respite, one of my favorites being an offer of occasional dog care or dog walking if we were unable to easily fit that into our schedules. In our case, our dog, Gracie, deserves such pampering. She is, herself, contributing a great deal to the recuperation from my Christmas operation. Gracie regularly sniffs and checks my bandages to make sure things are mending properly, and she reliably curls up warmly beside me when I take my afternoon (or at whatever time) naps. Despite the presence of cancer in our lives, Gracie is unabashed in expressing her exuberance for life in the moment. She reminds us all that we must revel in the same joy of life, however we might be experiencing it in the moment. She seems to be saying: “Life is always an amazing grace. Acknowledge it.”

    Appreciation

Many notes express appreciation for what we (the author of the missive and we, ourselves) have enjoyed and experienced together. Such notes underscore that none of us live our lives in isolation (recall John Donne’s memorable line: “No man is an Island”, and the meditations of Thomas Merton on Donne’s pithy observation.) Reflecting on happy communal experiences is always a good antidote to the annoyingly necessary self-attention required by recuperation and self-aware health-care.

    Guilt

I can hear my mother’s admonition: “Each of these notes deserves an individual, personal acknowledgment and reply.”
For a while, I kept the correspondence (along with the enclosed prayer cards, bookmarks, Mass cards and other remembrances) in a pile, to answer them, properly, as my Mother taught (and, indeed, as I was inclined to do). Somewhere along the line, I realized I’d probably never get around to acknowledging them, individually. It made me feel a bit depressed to have drawn such an unworthy conclusion.

    An honored place for blessings

On the delayed Christmas festivities our family joyously celebrated in the middle of January, this year, I received from Monica a precious gift. It is a beautifully-decorated, hand-plaited basket from Palestine which was described as a “blessing basket”. Into it, Monica had placed sample printouts from among the e-mails she and I had received over the past 18 months… ones that have done so much to buoy our spirits and have helped keep us in a state of emotional equilibrium, however delicate.
My “blessing basket” now rests in an honored place in our home. Today, I slipped into it, the cards and notes I had piled up to respond to, individually. All those prayers, thoughts and wishes represented by the scraps of paper are blessings, indeed. They are efficacious (I would dare say, essential) to healing. They are certainly required by us. They help us maintain a proper perception towards this stubborn illness. We are greatly indebted to the writers. We also appreciate, very much, the salutary effect we feel on receiving each of them.

    A Spiritual two-way wormhole

There was a delightful “Frank and Ernest” cartoon on the comics page of our newspaper this week. Frank claimed that Ernest was living proof that Descarte’s maxim: “I think, therefore I am” is not reversible. (This is quite true; a truth to which (I can’t resist observing) our Congress almost daily distressingly attests.)  Fortunately, its not true of our blessing basket. When our family recites Grace, or mumbles a prayer-in-passing, we now specifically include all those who are represented by our “blessing basket.” The blessings  we’ve welcomed, thus rebound to all those who so kindly continue to bless us. Thank you!  Know that you are blessed for your thoughtful graciousness and that, on “down days” we gratefully re-read them to regain our “good day” composure.

Chet