Learning curve—or flatline

Have I learned anything from my ordeal with cancer or from my struggle with my elderly parents' increasing infirmity or from all the books I've read on those subjects? Not much.

As my old friend K begins the dreary, dread-filled circuit of cancer treatment—blood-test batteries, ultrasounds and PET/CT scans, doctors' appointments, surgeries, pathology reports, chemo infusions, radiation—and my friend C accompanies his father along a similar path, I wish I could offer them comfort or shortcuts or secrets—or anything at all. I am sadder but not much wiser as a result of my travails. I have little to offer.

Nothing can really ease the agony of a life-threatening illness. You are stuck, essentially alone, in your own private hell. But a few strategies limited the damage for me. Because life never really settles into round numbers like 5 or 10, there are 11 that come to mind:

1. Write down your obsessive thoughts—maybe in a blog!—so you don't have to keep repeating them to yourself

2. Take notes—write down everyone's name and phone number and e-mail address and what he or she said—and transfer your notes to a computer file so you can search it easily

3. Keep a calendar of every medical event—from lab tests to treatments to doctor visits—on your computer

4. Get copies of lab and pathology reports

5. Keep every bill, annotated with the date and the check number of your payment, clipped to a copy of the relevant insurance report

6. If you don't get a call with the result within a day or two of a lab test, call the doctor

7. As much as possible, treat your illness (or your parents' illness) like a job: make lists and cross off completed tasks

8. Drink 8 cups of water or green tea every day

9. Eat 5 to 9 servings of fruits and vegetables every day

10. Take deep breaths

11. Get exercise (preferably in the form of yoga) every day

Is the right brain really right?

In the link I posted in my previous entry, a brain scientist describes her personal experience of having a stroke at the age of 37. In her case, the stroke took about four hours, and in the course of the event, she ping-ponged from one side of her brain to the other as the stroke shut down the opposite hemisphere completely. She had the rare opportunity of being entirely right-brained for a few minutes and then entirely left-brained, alternating back and forth several times. 

When her right brain shut down, her analytical, practical left brain made a quick objective reading of her symptoms, diagnosed a stroke and prompted her to take steps to get help. When her left brain was suppressed and her right brain took over, she slipped out of action mode and into being mode. She felt her oneness with the world. Indeed, in right-brain mode, she was unable to differentiate the molecules of her own body from those of the objects around her. The dissolution of self and the merging with her surroundings was blissful. Her experience as a right-brained being was clearly ecstatic, and her lecture is essentially a sales pitch for cultivating right-brain proclivities. Her presentation is fascinating and joyful and persuasive. It calls to mind rhapsodic accounts of meditation. Indeed, I believe she used the term nirvana. And I went to bed heartened that we all have an inborn ability to achieve a similar state. All we have to do is liberate ourselves from left-brain control and allow our right brain to do its stuff.

But this morning when I woke up, I began applauding the underdog left brain. After all, it was her left brain that saved her life by impelling her to respond to the realities of her plight.

Probably it's just my own nasty ("sinister!") left brain getting all defensive, but something about the singleminded veneration of the right brain sends up a red flag. Maybe it's pique that people prize something I haven't got. In my cranium, neither lobe seems to predominate. Indeed, at this stage of my life, both lobes seem a little atrophied. (The ultrasound tech who monitors me for ovarian cancer—I'm at higher-than-normal risk because I've had breast cancer—told me that my ovaries, once as plump as plums, have dwindled to the size of dried peas. My brain lobes seem to have suffered similar shrinkage and dessication.) At any rate, although I spend a good deal of my time on a yoga mat trying to shift into right-lobe mode, I feel fully appreciative of my oft-maligned left lobe. Indeed, it is my left-brain tendencies—alertness, organization, efficiency, determination—that get me out of bed and onto that mat several times a week. 

So I still think you should go to that link, but listen with your left brain as well as your right.

Stroke of yoga

Oh, dear, I can't seem to link this blog to this presentation, but trust me, you need to go here:

http://www.ted.com/index.php/talks/jill_bolte_taylor_s_powerful_stroke_of_insight.html

Odious comparisons

There's a woman at work who dislikes me. There may be others I don't know about, but I'm sure about her. And I don't blame her. She and I were treated for cancer at about the same time, and the path I took made her path more difficult. 

When I told my boss I had breast cancer, my boss told me to take off as much time as I needed and hired a sub to cover for me. The sub was redundant. I didn't take any time off. I clung to my place among living, healthy people. I didn't want to join the tribe of the sick. It wasn't easy showing up for work when I had drains hanging from my chest and a fluid-filled seroma swelling in my armpit and chemo nausea and an itchy wig that bore no resemblance to my own hair, but I could do it. It wasn't courage, however. It was cowardice. Being at work was being normal. Taking time off and being home alone with my thoughts would have been terrifying.

I got a lot of praise for my "great attitude" and "strong work ethic." I resented the former (would I have been to blame if I gave the—accurate—impression that I was bummed out?), but I took pride in the latter, even though it didn't reflect the source of my motivation (fear!).

Meanwhile, a colleague in another department who was battling a different kind of cancer took a leave and moved in with family members in a different city so that she could have their support while she underwent a particularly grueling form of chemo, which involved infusions directly into her abdomen. I kept in touch with her a bit over the six months or so that she was out of the office and got reports of how desperately ill she was.

Eventually, people started making comparisons between her handling of her disease and my handling of mine—even though we had completely different kinds of cancer in completely different organs with completely different treatments. I heard rumors that my colleague had been given a hint that she might lose her job if she didn't return to work soon. 

I know she must have had some awareness of the running commentary. And she must have seen me as the grownup equivalent of a grade-grubbing, ass-kissing classmate. She must have resented me for making her look bad. And the stakes were way higher than her getting a C to my A. My "strong work ethic" put her job at risk. So far we've both held on to our jobs, despite several rounds of layoffs, but I regret that with so much in common, we are not better friends, and that at a time when she was miserably ill, she had to suffer by comparison with me. 

A milder tension has developed between me and a good friend who was treated for breast cancer shortly after I finished treatment. Whereas I was able to get by with an occasional Tylenol or Advil after my various surgeries—the stronger stuff brought on constipation, more hateful to me than postsurgical discomfort—her pain was intense and still has not abated. Her doctors have pressured her to give up the opiates she feels she still needs. It's clear that once again I've set a "good patient" standard that causes grief to someone less fortunate.

"Comparisons are odious," wrote John Donne. True enough.

The new normal

The other day, C was going through my iPhoto pix to snag some for herself, and she came across some before and after photos from my mastectomy two years ago. She examined them closely, then said, "You know, Mom, you looked really weird with boobs." 

Uplifting tails of the kitty category

Love and smarts come hard and slow to some. My kitties, for example. We got Ivy for my daughter C on her ninth birthday. Ivy was a dumb blonde—white with black beauty spots, including a lovely heart at the base of her tail, and not much gray matter between the ears. She was terrified of her own tail. Sometimes she would catch sight of it and dash for the underside of the couch. Proof of her idiocy: she loved me and loathed every other human. Not a single other animal has made that mistake. Any being with hair, scales or shell knows that Other is the one to love in our house. He feeds everyone, including me. So Ivy spent most of her life hiding from the wrong person. She had this way of making anyone who approached her feel like a kitterast. What with that and the way she mostly hid under the furniture, people pretty much left her alone. She spent her days licking herself and sleeping. Her immediate family—i.e., Other, C and I—acknowledged that she was a dud, but a sweet dud.

When Ivy was about 5, I had another birthday problem. There was nothing C wanted that I could bear to give her. Now I know it's totally wrong to get an animal for a kid just because you can't think of another present—but that's what I did. And it was like night and day: Ivy was white, and Iggy was black. Ivy was dainty and demure. Iggy was a rascally scofflaw. He was a crowd pleaser. She was social poison. He wanted to play. She wished he were dead. 

And that's how cat life went for several years in our apartment: Ivy hid, while Iggy climbed the walls, caught cockroaches and strutted about showing off the twiggy legs writhing between his teeth, snatched birds from the deck and dismembered them behind the couch, chased sunbeams scattered by the prism hanging in the window, opened closed doors with his bare paws, shredded the clothes in my closet, barfed into the radiator grate, used the entire house as toilet paper, ate his food and Ivy's, and grew to twice her size. It was like having one supercat and one ghost cat.

But over the past year, as Iggy has continued his reign of terror, Ivy has begun to change. At the age of 9, which must be late middle age in cat years, she has emerged from beneath the couch and begun to ... play. It's weird. I've caught her striking out with a paw at Iggy then scampering out of his reach—in a kind of joyful teasing way. I've seen her chasing her own tail—and not looking scared. She's begun to warm up to Other. There's something touching about these tentative forays, as though she's practicing to be a real cat and might get embarrassed if you caught her. It's also inspiring. It's as if nine years after her actual birth, she is finally coming alive.

Now if a cat can make serious changes in her behavior, achieve a major attitude adjustment, wake up and enjoy life, humans can too. There's proof in every domain. If an electorate that TWICE voted George Bush into office can do an about-face and elect Barack Obama, anything is possible. 

Yogabama

If further proof were needed that all things relate to yoga, Barack Obama's Inauguration speech yesterday was really a call to karma yoga, the yoga of service. Namaste!

Old ladies having fun

The women who work as home aides in San Francisco are mostly Filipinas and mostly overqualified. In their native country they are registered nurses, schoolteachers, professionals of various sorts. Despite low wages and long hours, they all say they love their work in this country as caretakers of the elderly. Indeed, some are quite elderly themselves. Two of the four aides I've met who have taken care of my mother looked reasonably young but confided that they were 69. Could I have misunderstood? It's a 24-hour-a-day gig, and they work five days straight, then are relieved for two days. And my mom gets up to use the bathroom several times a night. Not a job for the flimsy or fainthearted. 

But all four have been tireless in their attention and good humor—and courage. It's daunting to give a shower to an 82-year-old in a long-leg brace who has osteoporosis and a history of strokes. Or at least I thought so. I was quaking the day I was asked to assist in such an ablution but charmed when the aide instructed my mom to wash her "flower." My mom and I looked at each other, puzzled at first, then amused, as the aide grabbed  the hand-held shower head and began spraying her, um, vulva. 

My mom, who was never a cuddly person, seems to love the physical attention she gets from the aides. One day I came home to gales of giggles. My mom and her aide M were carrying on like schoolgirls as the aide penciled in my mom's eyebrows. When I walked in they looked up guiltily, like a couple of six-year-olds caught with their mothers' makeup bags. 

Meditation is like driving, but without the fear

Other and I drove our daughter C and her friend E back to Skidless today, four hours each way. I drove to, Other drove fro. Since I rarely drive these days, I am not very good at it and periodically get a stab of pure panic that I will kill something. At the same time, since I grew up driving a lot in California, it feels like second nature, and I tend to drift into auto-drive, especially on the freeway. So this morning, as usual, I repeatedly felt the flush of fear as I realized that I had glazed over, and snapped my attention back to the road, forced myself to concentrate, check the side-view mirrors, the rear-view mirrors. And it reminded me of meditation: the tendency to float off into past, future and fantasy, and the effort required to draw the attention back to the present. Just like life.

Forbidden words

At a wonderful lunch (salmon with white peaches and figs, broccoli rabe, vegan sushi, berry and mango tart) at my friend B's, I had an outburst I'm ashamed of. I was talking about the stress I feel watching my parents slide into poor health and the frustration I feel about their stubbornness in insisting on living independently, which paradoxically makes them more dependent on my brothers and me, and I finally said, "Why don't they just die!" The room fell silent. Everyone was shocked—myself included.

I don't really want them to die. I just want them to be sensible—and to behave in a way that doesn't scrape the sheathing from my nerves and twist them into a short circuit. That sentiment—Why don't they just die—is one of the things I fear most about a cancer recurrence. Having watched me struggle through surgery, chemo and radiation once, my friends and family will secretly wish I would just die quickly and spare them the ordeal of watching me die slowly. My continuing existence will be a hardship, a source of pain rather than pleasure. And I know just how they would feel.

There is another side of the story, though, and that is that I take a huge interest in watching my parents at this particular time in their lives. I've never seen anything as valiant as my dad's barreling madly through the halls of the rehab center in his walker, looking demented in his furious determination. "I want to get home to your mother," he said. Or anything as poignant as the arduous bill-paying of my mom, who can't reliably put the right entry on the right line even though her handwriting retains the ornate flourishes and the sharp clarity of etched crystal. Their fierce and frustrating death grip on their old way of life touches me. They don't want to identify themselves as old and needy, just as I didn't want to identify myself as sick and scared when I had cancer, so just as I ran, horrified, from the first cancer-support group I attended, so they recoil from the notion of assisted living. I didn't want to be one of the sick people I saw in the group, and they don't want to be old and feeble like the people they see in senior residences. But eventually, I think, just as I finally found relief in the company of people who shared my ordeal, they will welcome the relief of no longer having to pretend to be what they no longer are.

I love my life!

I think some people are mystified about why I was so traumatized by my parents' recent health crisis. It wasn't just about the health crisis, and it wasn't just about my parents. It was about me. I was airlifted out of my life and into theirs. Over the three weeks that I was in San Francisco, I began erasing my appointments from my calendar and replacing them with my parents'. My life vanished before my eyes. For a while, I despaired of ever getting it back. And it made me realize how much I love my life. I love my kids and Other. I love my cats. I love my job. I love my friends. I love my apartment. I love New York. I love getting up early in the morning and having an hour or so to savor the house (well, after I clean up the cat vomit and sweep the kitty litter off the floor). I love all the trivial little chores and pleasures that are mine, all mine.

So it was a particularly happy birthday when I quietly turned 59 yesterday. First of all, there was a time a few years ago (three and a half to be exact) when my cancer diagnosis made me fear I would never see this birthday. Second, I spent the day distracted from my troubles by my job, which, miraculously, I still have. Third, I got a dozen phone calls and e-mails from friends in celebration, perhaps most notably a singing phonogram from one of my oldest friends, K, whom I love all the more fiercely as she embarks on her own journey with cancer (uterine). Fourth, I spent the evening in the humble comfort of watching Mean Girls on television with my daughter—who was once but is no longer a mean girl! Usually, Other tries to put together a big celebration for my birthday, arduously prepared food, many friends, a big event. I love it. But in a season when I spent Christmas and New Year's in San Francisco, it was spectaculor to spend my birthday quietly at home.

Black becomes white

An interesting revolution has taken place in my family: a black sheep has turned white. Maybe it's just ugly sibling foolishness, but I'll be frank: I've always thought of my younger brother as a black sheep. He was a compulsive liar as a child, repeatedly ran away from home, struggled in school (still don't know if he ever graduated), got into trouble with drugs early and often, got into car accidents, went to Northern California to live off the grid in a kind of barter economy, knocked up a young country girl, married her, divorced her and so forth. I know there are other ways of enumerating his history that would emphasize his successes and his good intentions. But this is how I saw him—incorrigibly wrongheaded and irresponsible. But it turns out I was wrong. Or maybe I was right about his younger self, but his 53-year-old self has been a revelation.

For one thing, he showed up when the 'rents had their health crisis, and he helped me both practically and emotionally. And then, miraculously, he stayed on after I left to oversee our father's homecoming from rehab. And we had enjoyable, thoughtful conversations whenever we were together. 

So I almost lost my parents, but I gained a brother I didn't know I had. In fact, I'm wondering now if maybe I'm the black sheep in the family. 

New Year's Resolution

Arriving in San Francisco to respond to my parents' simultaneous health crises (see previous post) was like landing on Mars without going to astronaut school. I knew no one, had no authority to act on behalf of my parents, had no experience dealing with such dire events, didn't even know how to drive my parents' Prius and didn't know my way around in any case. I was so panic-stricken by the urgent and continually unspooling demands that I couldn't eat, couldn't sleep, couldn't think. I wept uncontrollably—in Whole Foods, at Staples, in the street, to any stranger who would listen. I worked from 6 every morning till 10 every night, trying to offer comfort, put in place a care-giver apparatus that would outlast my stay, and make notes for my brothers, whom I was counting on to relieve me.

Despite what anyone would acknowledge as a job well done, I was overcome by a sense of failure since I had not accomplished a long-term solution. My mother will survive her broken knee and her stroke, and my father will survive his broken ribs, sacrum and pelvis, but they are not in an affordable, safe living situation, and they will injure themselves again. 

Two people, both friends of my parents', shared words that saved my sanity. Both of these FOMPs said essentially the same thing. One wrote me an e-mail that read: "Remember, regardless of how hard you try, many things are out of your control. Just take it day by day." Acknowledgment that things were out of my control was comforting, perhaps because it absolved me of responsibility. Another FOMP, a native of India, gave me a lift home after I bumped into him at the skilled-nursing facility where my father was undergoing physical therapy. He said that in Eastern philosophy, there are three secrets to life: "right" work, "right" means—and letting go of the result. I was doing right work with the right means (aside from the whining and blubbering)—but I was clinging to a result, and that was driving me mad. I can't say these two conversations brought immediate peace of mind, but they helped. And both are magically in sync with yoga philosophy.

So my New Year's Resolution is simple and singular and diabolically challenging: to live my yoga every day, on the mat and off.

What's the good of prescience?

Prescience is a vastly overrated thing. In November, after my mother, who had a stroke two years ago, broke her knee cap and failed to seek medical attention for three weeks, resulting in a permanently bifurcated patella, I spent a week railing at my aging parents to give me durable power of attorney. I believe my exact words may have been "What if Mom has another stroke and Dad gets hit by a bus and you need someone to handle your affairs until you can take over again?"

Well, on December 13, my mother had a stroke in the morning, and as my father was leaving the hospital on foot after bringing her some personal belongings, he was hit by a bus and taken to the ICU of another hospital with four broken ribs, a fractured pelvis, a fractured sacrum and internal bleeding in his skull, chest cavity and kidney. And it did me no good whatsoever to have dreamed up that precise scenario a month earlier. To add pathos to pathos, when I called my brother, he told me that my sister-in-law had just been told she has uterine cancer. 

I flew to San Francisco the next day. Now just to show you that the population of this world is wondrously varied, here are the reactions of the other two condo owners in my parents' building: When I arrived and let myself in to No. 3, I called No. 2 to tell her what had happened to my parents and to let her know I'd be staying in the apartment while I oversaw their care. "But who's going to take out the garbage?" she asked. Shortly thereafter, No. 1 showed up at the door with fresh-baked cookies and asked if there was anything she could do. "I can take them to doctor's appointments," she offered. I told her that because of her broken patella, my mother needed a wheelchair transport. "How much could she weigh?" scoffed the beautiful, willowy No. 1. "I can carry her."

Three weeks later, my mom is back at home with a 24-hour aide, my dad is in rehab struggling to regain his strength, and my sister-in-law is recuperating from a hysterectomy (no further treatment needed). And I'm finally back in New York, still without power of attorney.