Ulysses S. Grant chain-smoked cigars. After his presidency, he contracted aggressive, advanced and untreatable throat cancer. His family was relatively impoverished (being President wasn’t a road to wealth in those days, apparently), and by way of leaving something tangible behind, he contracted on favorable terms with Mark Twain’s publishing house to produce his memoirs. Note Twain’s personal altruism—he offered such excellent terms because he didn’t want the Grants to be poor [1].
A couple of doctors were assigned to see Grant at least twice a day, with the objective of keeping him sufficiently functional and pain-free to finish the manuscript. A team of researchers was provided. Grant dove in and started writing. Towards the end, he was alternating doses of cocaine and morphine but still moving forward. A few days before he died, he handed Twain the manuscript.
It was an enormous literary and financial success. The Grant family was solvent, and the critics raved. A seriously workmanlike way to end an extraordinary life.
I wish I had that kind of single-minded purpose, that drive, that desire to leave a meaningful legacy. But this is me we’re talking about. Lazy. Lumpish. Procrastinationary (word?). Generally, I LIKE sitting around picking at my guitar, making bad art work from sketches and cut paper, writing bad poetry, hiking, and taking bad photographs whenever possible.
All this is preliminary to the real message of this entry. I met with a whole round of doctors this week, both before and after I was admitted to the hospital on Tuesday because of rather spectacular bleeding. The message from my radiation oncologist was this: “You need to start having fun. It’s time to fuck the rest of it”.
And the reason he gave me this message? He figures I have 6 to 18 months to live. The tumor now residing on my palate will grow and become painfully symptomatic in 3 months, and after that it’s just a matter of time. Of course there are a million alternate possibilities and pathways. But the medical profession’s best guess is that by Thanksgiving 2014 I’ll be dead if given only palliative (symptomatic) care and pain management.
Beyond that, things don’t look much better. Apparently focused radiation is feasible, but it has only a 30% chance of controlling the tumor, and will itself introduce around a 10% chance of immediately fatal side effects. Radiation would be accompanied by chemo, which will have its own very discomfiting impacts on my physiology.
At the moment, I’m not sure what I’m going to do. If I opt for active treatment and it works, I’d be trading 6 months of post-radiation hell (just like last time) for a cancer-free future. But that’s only a 30% chance of success. If I opt for active treatment and it fails, I’d be taking the last year of my life and turning it into radiation-sick hell to no purpose.
Right now, I can think, write, “talk” (various technologies), play guitar, cook, and do work, including writing a book on urban ecosystems and returning to professional work for my company if they want my help. If I continue to be able to work, I’m tempted to just let the disease run its course and opt for hospice care and serious pain control at the end. But, as I say, all options are still on the table.
That’s it from here in The Land of Good News. I suggest you switch over to the “all bad news channel” for some really gruesome perspective!
In the meantime, my doctor’s advice is good for everybody at every time. “HAVE FUN. FUCK THE REST OF IT.” You only get one shot at life my friends. You can learn from my experience. Wring as much out of life as you can while you can. That way, you won’t have any real regrets when the jet engine falls out of the sky onto your bed.
My love to you all. Tomorrow I will update my professional weblog over at http://www.aehsfoundation.org/. Go to the lower left on the AEHS Foundation home page and click through to my sustainability weblog, PeopleSystems and Sustainability. Have fun, everyone. Ask any questions that come to mind. I’m looking forward to hearing from you and seeing as many of you as possible before I’m toast. Got a good year-and-a-half left to accomplish all that. Or, we could all rent the movie The Guitar and hope my tumor disappears like hers did. I’m good for that!
Notes
[1] Waugh, J. 2009. U.S. Grant: American Hero, American Myth. University of North Carolina Press, Chapel Hill.
No matter what you decide to do, it's the right decision, and we'll hang in there with you. xxoo gail
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