[cancer] More detailed thoughts on mortality
Recently I observed:
It occurred to me recently that one way to think about my cancer risks is that we're all dying, I'm just probably dying a little faster than most of my peers.
Somewhat in parallel to that and a few days later, klwilliams remarked in comments to another post of mine:
I realized what mortality *meant*: you don't get to find out how all the stories end.
She really struck a chord for me with that observation.
the_child and I have occasionally discussed the hypothetical of whether one would choose to live forever, if one could. (These conversations began even before my initial cancer presentation, and have recurred from time to time since.) She and I both think we would choose that, even at the obvious emotional costs, simply because we both want to see what happens next, next and next after that. We want to know how the stories come out, in short. Where the new ones come from, how the current ones evolve, how they all end. Or not, for stories don't really end. They just turn into new stories.
For my own part, I made it through the first round of cancer in 2008 so quickly and with so much surprise that I'm not sure I ever took it truly to heart. My oncologist at the time told me my cancer was unusual and very unlikely to recur - I was given 99% odds of not experiencing any metastasis. I went on with my life, happy and confident that we'd beaten it.
When my lung metastasis was detected in 2009, we spent months dealing with and arguing the diagnosis. The oncology team literally didn't believe their own clinical evidence both at first, and for quite some time after as we pursued additional tests. The recurrence was very much a surprise to every one. Still, I went through the lung surgery and the subsequent non-adjuvant chemotherapy in the first half of 2010 convinced we were going to beat it, and I'd be fine.
The upset and emotional disaster of the departure of calendula_witch from my life at the end of 2010, followed a few months later by the diagnosis of the liver metastasis I've just concluded chemotherapy for, finally broke my already battered optimism. At a fundamental level, I've gone from believing that I would beat this to believing that this disease is going to claim me in the not very distant future.
I'm not talking about depression, or a difficult emotional reaction. More like a baseline conviction that I've already lost the game and we're just playing for time. To be clear, this is neither my clinical diagnosis nor prognosis. At the moment, I am considered to have "no evidence of disease following resection." That's the clinical diagnosis. My prognosis is a 70% chance of recurrent metastasis.
It's probably coming back.
And deep in my heart, I believe it will get me.
This is why I flash on stuff like being irritated because I don't know if I'll live long enough to see both halves of The Hobbit movie. Whenever this comes back, if the metastasis is in the 'right' place, we can treat with resection and chemotherapy, but I'll lose another productive year out of my life as I've lost much of the last two years. If the metastasis is in the 'wrong' place, i.e., not surgically resectable, I'll receive life extension therapy but my time will likely be counted in months from that point. Even if it is in the 'right' place, there's only one more chemotherapy option available to me. After that, all the metastases are in the 'wrong' place, resectable or not. In effect, every scan I go through is a death lottery for me. (The next one of those is February 14th.)
So the mortality is always there. I'm not dying right this moment any more or less than you are, but like I said, on the whole I'm probably dying rather faster than most of my peers. And klwilliams put her finger on it. I won't see how the stories come out. The stories of my parents' lives. The story of my daughter's growth to adulthood. The stories of my own characters, their fictive worlds and desires. The stories of my friends, my loved ones, everything. Even movies I care about.
In a sense, I'm already mourning what isn't even yet guaranteed to come. My convictions are emotional, not based on logic or clinical evidence. But they are strong, bone deep. I've been battered too long, too many times, endured too many losses to cancer already, to believe that I'm getting out of this one clean at this point.
I can remember when life seemed like it would go on and on. I miss those days.
It occurred to me recently that one way to think about my cancer risks is that we're all dying, I'm just probably dying a little faster than most of my peers.
Somewhat in parallel to that and a few days later, klwilliams remarked in comments to another post of mine:
I realized what mortality *meant*: you don't get to find out how all the stories end.
She really struck a chord for me with that observation.
the_child and I have occasionally discussed the hypothetical of whether one would choose to live forever, if one could. (These conversations began even before my initial cancer presentation, and have recurred from time to time since.) She and I both think we would choose that, even at the obvious emotional costs, simply because we both want to see what happens next, next and next after that. We want to know how the stories come out, in short. Where the new ones come from, how the current ones evolve, how they all end. Or not, for stories don't really end. They just turn into new stories.
For my own part, I made it through the first round of cancer in 2008 so quickly and with so much surprise that I'm not sure I ever took it truly to heart. My oncologist at the time told me my cancer was unusual and very unlikely to recur - I was given 99% odds of not experiencing any metastasis. I went on with my life, happy and confident that we'd beaten it.
When my lung metastasis was detected in 2009, we spent months dealing with and arguing the diagnosis. The oncology team literally didn't believe their own clinical evidence both at first, and for quite some time after as we pursued additional tests. The recurrence was very much a surprise to every one. Still, I went through the lung surgery and the subsequent non-adjuvant chemotherapy in the first half of 2010 convinced we were going to beat it, and I'd be fine.
The upset and emotional disaster of the departure of calendula_witch from my life at the end of 2010, followed a few months later by the diagnosis of the liver metastasis I've just concluded chemotherapy for, finally broke my already battered optimism. At a fundamental level, I've gone from believing that I would beat this to believing that this disease is going to claim me in the not very distant future.
I'm not talking about depression, or a difficult emotional reaction. More like a baseline conviction that I've already lost the game and we're just playing for time. To be clear, this is neither my clinical diagnosis nor prognosis. At the moment, I am considered to have "no evidence of disease following resection." That's the clinical diagnosis. My prognosis is a 70% chance of recurrent metastasis.
It's probably coming back.
And deep in my heart, I believe it will get me.
This is why I flash on stuff like being irritated because I don't know if I'll live long enough to see both halves of The Hobbit movie. Whenever this comes back, if the metastasis is in the 'right' place, we can treat with resection and chemotherapy, but I'll lose another productive year out of my life as I've lost much of the last two years. If the metastasis is in the 'wrong' place, i.e., not surgically resectable, I'll receive life extension therapy but my time will likely be counted in months from that point. Even if it is in the 'right' place, there's only one more chemotherapy option available to me. After that, all the metastases are in the 'wrong' place, resectable or not. In effect, every scan I go through is a death lottery for me. (The next one of those is February 14th.)
So the mortality is always there. I'm not dying right this moment any more or less than you are, but like I said, on the whole I'm probably dying rather faster than most of my peers. And klwilliams put her finger on it. I won't see how the stories come out. The stories of my parents' lives. The story of my daughter's growth to adulthood. The stories of my own characters, their fictive worlds and desires. The stories of my friends, my loved ones, everything. Even movies I care about.
In a sense, I'm already mourning what isn't even yet guaranteed to come. My convictions are emotional, not based on logic or clinical evidence. But they are strong, bone deep. I've been battered too long, too many times, endured too many losses to cancer already, to believe that I'm getting out of this one clean at this point.
I can remember when life seemed like it would go on and on. I miss those days.