It is early in the morning on December 23, 2010. I should be sleeping but am awake with excitement. Today was a "full energy" day. This morning Morgan and I did the big grocery shopping for Robyn's Christmas Eve Birthday Party and our Christmas Day Feast. I spent the afternoon making lasagna for the birthday party from a traditional family recipe handed down from my Dad. Yummy! This evening Jerome and Kelly visited for dinner and a Christmas movie ("Christmas Vacation" with Chevy Chase). They are just back from Jerome's home in Hazelton so there was much to catch up on. Jerome has wonderful work as a teaching assistant and basketball coach in the Hazelton School District.
It feels good to have gotten so much done and it leaves tomorrow totally free. Alas, I will probably sleep most of it away now that I have surrendered much of this night to insomnia!
"The hopes and fears of all the years are met in thee tonight..."
Wow, does this ever seem to be the way it is with me this Christmas. So many hopes and fears converging. My situation seems outwardly dire. My level of medical care is "palliative". I'm living with an indwelling catheter, managing bowel incontinence with "Depends", walking with the help of a cane, and bearing this "pain-in-the-ass" cancer with ever increasing doses of Morphine and its various derivatives. I'm living through what, in most likelihood, is the terminal stage of a cancer against which I have never really had more than a "faint hope". Fear abounds!
And yet I do remain hopeful. Not just hopeful of a dignified death and an ongoing existence of wholeness and bliss beyond the grave (much as this is!), but hopeful of an ongoing life of joyous love and faithful living in this plane of space/time existence. Perhaps I am just having another late-night experience of one of morphines beloved side effects - an exaggerated sense of well-being!
A Glimmer of Hope.
At present I am undergoing a series of scans (CT, PET, MRI) which will be evaluated by a local surgical team to see if I might be a candidate for a "sacral resection". A sacral resection is a significant surgical procedure which sees the collaboration of orthopaedic and general surgeons in the removal of all or part of the sacrum and all of the soft-tissue cancer in the pelvic region. The sacrum is then reconstructed using artificial bone and steel and permanent incontinence is resolved with a colostomy and permanent urinary catheter.
To be eligible for this extensive procedure it must be shown firstly, that I am free of other metastacies; secondly, that the cancer is not spreading up the spinal nerve sheath; and thirdly, that a viable orthopaedic reconstruction option exists given the extent of cancerous bone that would need to be removed. This is indeed a lot to ask.
I've been aware of this option for sometime but only began to pursue it this Fall when it became clear that the chemotherapy was losing its grip on the cancer. I've been consulting various doctors at the BC Cancer Agency and BC Spinal Centre for the last month or two. Not all have been encouraging. It is now getting down to the nitty gritty! I've had the CT scan and am scheduled for the PET scan in early January. An MRI is pending too. Soon I hope!
"Delusion of Repreive"
Thanks to my friend Peter Alexcee I have been reading Viktor Frankl's classic work "Man's Search for Meaning". Frankl, a holocaust survivor and psychiatrist, uses the term "delusion of reprieve" to describe the belief that many death camp prisoners held that they would be saved, rescued, or otherwise redeemed from their mostly inevitable death. "In psychiatry there is a certain condition known as delusion of reprieve. The condemned man, immediately before his execution, gets the illusion that he might be reprieved at the very last minute." Viktor Frankl
I don't think that there is any doubt that late-stage cancer survivors can experience this phenomenon. There is always one more drug, one more surgical procedure, one more clinical trial, or one more exotic alternative that is finally going to rid us of this dread disease and allow us to return to the lives we had before, or even better lives! From the perspective of survival this is actually not a bad outlook to have.
Perhaps this then is the cause of my tragic optimism at this late stage of my cancer journey, a "delusion of reprieve". And yet! My basis for hope in this plane of existence is rooted and grounded in a very real and tangible possibility. Or perhaps my doctors are indeed collaborators in my "delusion of reprieve"! We all want to believe that "cancer can be beaten"!
Even beyond this particularly hopeful possibility there are a number of other options that offer hope of some life extension and much life enhancement. All shall soon be revealed.
As I took out the Christmas decorations this year I distinctly remembered putting them away last year and doubting at that time that I would be here now to enjoy another Christmas season. And yet here I am. So enjoy it I will!!
Do have yourself a very Merry Christmas... Love Rob; in Vancouver
O holy Child of Bethlehem, descend to us, we pray;
Cast out our sin, and enter in, be born in us today.
We hear the Christmas angels the great glad tidings tell;
O come to us, abide with us, our Lord Emmanuel!
