Cancer, shmancer, abi gesund.  Roughly, cancer, shmancer, as long as you're healthy.  On the one hand, the phrase is dark humor---ignorance or denial or defense.  On the other, however, it's an accurate description of how my days go and how I react to what's going on.  The cancer is there, and it's doing whatever it is that cancers do.  Every morning I take my chemo pills, I get my anti-coagulant shot, I swallow more pills to counteract the effects of the chemo treatment--and that's about all that I can do.  Cancer/shmancer--there's not much more to think about.  Well, of course, there is, but I can't really spend every day contemplating mortality.

What does influence my days more directly is whether I'm feeling healthy or not, whether it's a good day or a bad day.  I start every day with a handful of pills washed down with OJ, a bowl of cereal, and several cups of coffee.  (For some reason, my kidneys seem to be working better with the tumor than they did before: instead of one cup of coffee = one trip to the bathroom, I can drink several cups with no effect.)  Then I have to wait for two to three hours before I can take the chemo.  I plunk myself down in my Archie Bunker chair equipped with a special pillow with a cutout for the back of my tuches.  On a table to the left are my Kindle and my laptop; on the piano at the left are my tablet, my cell, and the remote control.  Mohamed gives me my once-a-day shot in my stomach after we try to remember which side gets it today.  And it's then that I have the most energy I'll have all day.  I blog and do e-mails and watch "Morning Joe" or "Up with Chris Hayes."  After 2 1/2 hours, I take the chemo pills, and then I have to wait for another hour before I can eat.  Although my appetite comes and goes at other times of the day, since I know I have to wait for another hour, it's then that I'm sure to get hungry.

Next comes showering, and suddenly I'm exhausted.  Something I've done every morning for all of my adult life has become an ordeal.  After the shower, I text Mohamed if he's at school, just to let him know I haven't fallen ("and can't get up"--or "can't reach my drink," as we used to joke).  As one of the therapists said, a fall would be "a catastrophe."  Getting dressed in my uniform, which consists of sweats, a t-shirt, and a hoodie, is also time consuming.  The hardest part is putting on my right sock.  If I'm not going out, it's a ankle-high white sock, which is easier to put on, but if I'm going out, I want a longer sock so that I don't cross my legs and expose a skinny, white, hairless shin.  I have to remember to put my left arm in the shirt first because the left shoulder is sore, and it hurts to try to fit it in second.  Through all of this, I have to keep standing up and sitting down because I can't stand on one leg.  I've become aware that I make little groaning sounds every time I stand up, sit down, climb stairs, hear my stomach grumble, or just feel like it.  That must be extremely irritating to Mohamed (I could do all these things without the groan, I'm sure), though he's never said anything.

And then it's time to face the day ahead.  Somehow I never get bored; there's always something to read or something mindless to watch on TV.  But what's always present is an awareness of whether this is a good day or one that's not so good.  I know I'm going to take a nap or two.  It's not a choice; suddenly my mind and body shut down.  The doctors are very casual about this: of course, you get tired.  You're fighting cancer, taking daily chemo, and taking three blood pressure meds to counter the effects of the chemo.  And if I have to, I can fight through the fatigue for awhile.  Much worse is the diarrhea, which is completely unpredictable, except that it's a constant threat. I love going out for lunch or dinner, but I always take an extra Imodium before I go out and am aware of restroom locations in all restaurants.  (TMI?)   And nothing is more debilitating than a day like yesterday when I didn't dare leave the house.  One of my oldest friends called when I was napping, but I didn't have the energy to call back, and what was there to say except to recount my G-I troubles?  Not exactly a charming conversation.

It's my "new normal," as they say.  Cancer, shmancer--not much more I can do about that; abi gesund--now that's what really counts.

There's nothing to be frightened of.  A couple of posts ago, I mentioned that I was re-reading Julian Barnes's memoir, Nothing to Be Frightened Of.  It was the first book I had read on my Kindle, chosen because I like Barnes and find his writing witty and graceful.  But I was disappointed in the book.  I had read it, however, before I was diagnosed with cancer, and I wondered whether I would find it more powerful now.  The book is usually classified as a memoir, and the first chapters are indeed autobiographical (though not in a straightforward way), but it becomes a series of meditations on death, religion (or lack thereof), and memory.

The title seems at first reassuring: death is nothing to be frightened of.  But it has another resonance: what do we have to be frightened of?  Nothing(ness).  And for Barnes, it's the second, less obvious, meaning that haunts his thoughts.  He's a great classifier.  There are those who are afraid of death, but not of dying (Barnes himself); those who are afraid of dying, but not death (Barnes's brother, a philosopher, who is a foil for many of the arguments in the book).  I'm with his brother, but I do wonder what happened to two other groups: those who are afraid of both dying and death (a large group, I'd guess) and those who are afraid of neither.  Barnes is much concerned with le reveil mortel, that moment when we become aware of our finitude.  And he's quite competitive about that awareness, envying those for whom it has come earlier  or more dramatically than for him.  With all the literary references in the book, Barnes omits Dickinson, a poet who describes over and over again that moment, most famously in the poem that begins "Because I could not stop for death" and concludes with "Since then -- 'tis Centuries -- and yet / Feels shorter than the Day / I first surmised the Horses' Heads / Were toward Eternity --."

The book opens with this assertion: "I don't believe in God, but I miss Him."  When he asks his brother what he thinks about this formulation, the brother replies, "Soppy."  (I'm with the brother.)  Another of Barnes's classifications is a strange happiness hierarchy: 1.  Those who don't believe in God and don't fear death.  2.  Those who believe in God and don't fear death. 3.  Those who believe in God and hence fear (and desire) death.  4.  Those who don't believe in God and fear death.  Given Barnes's agnostic nostalgia for God, I'd think he could make a British-ish version of Pascal's wager and surrender his agnosticism in order to move up a notch.

The chief influence on Barnes's book is explicitly the French writer Jules Renard, whose life and the deaths associated with it are recounted and speculated about and whose ideas are both echoed and countered.  Before Renard, it's Montaigne's Essais that, in both their ideas and their tentative structure, influence the (for me) frustrating recursiveness of Barnes's work.  Among English writers, it's Somerset Maugham (who was himself influenced by Renard) and Philip Larkin who are most often cited.  Two quotes from Renard: "It's when facing death that we become most bookish" and "I don't know whether God exists, but it would be better for His reputation if He didn't."  What Barnes lacks in this anxious memoir is the acerbic edge of that last quotation.  There are many fascinating anecdotes and pithy, "bookish" allusions.  But the book is finally more worried essays, attempts, than cohesive whole.

So far, I've gotten a lot of nice comments about the blog.  Several people have commented on my matter-of-fact attitude.  (Yeah, that's me.)  Others have said it's obvious I loved teaching and can't give it up.  (Maybe there's been too much of this.)  My friend Jill, who will be reading this, used to say that I might have a high I.Q., but I have a low E.Q. (emotional quotient).  I was always somewhat miffed by that comment, but looking back at what I've written, there does seem to be a consistent and not very emotional tone. 

I want to say then that not one word of this blog would be the same if it weren't for Mohamed, who has unfailingly loved and supported me through all of this without a word of complaint.  One of those cliches that's a cliche because it's true is that no one outside a relationship (and often even those within a relationship) can really understand its nature.  From the outside, we seem an unlikely pairing--the age difference is huge, the cultural background couldn't be more different, he's a Muslim, I'm an atheist.  But everyone who has met Mohamed can see immediately what a good person he is and how deep is our love.

We've been together for five years--two of them long distance, three since he moved to Topeka.  The first four years were fun and exciting, including a summer in Paris.  The last year he's shown his quiet strength.  For the first days after I came back from the hospital, I couldn't make it upstairs in the house to go to the bathroom.  I'd talk about loss of dignity, but there wasn't much left to lose.  Mohamed never flinched.  Although there are many things I can do now, there are others I still can't.  Because the cancer destroyed a lot of my left scapula, extending my left arm (and I'm left-handed) and lifting things is often painful.  My right leg is pretty strong, and my gait is decent, but going up and down stairs is still something that requires some effort.  Every morning I pull up my shirt, and Mohamed gives me my anti-coagulant shot.  He goes to every doctor's appointment (and was there 24 hours a day during and after my surgery) and remembers exactly where to go and what was done the last time.  He asks the right questions and remembers more of the answers than I do.  Although I am dependent on him in many ways, he never makes me feel dependent.  Of course, he would say, he does these things for me because we're in this together.

In five years, we've had exactly one argument, and that lasted about 15 minutes.  And for some reason, he still finds me attractive and sexy.  I see the white hair and wrinkles and limp and groan.  He sees the same traits and smiles.

So of all the good luck that's come my way in life, I couldn't have asked for someone better to share this time with.  Love may not be all you need, but it sure the hell helps.

Dry (and miscellaneous) thoughts of a dry brain in a dry season...

I seem to have grown more thin-skinned in old age--not figuratively, but literally.  The tiniest scratch reacts like a cut, and with the anti-coagulant shots every day, the blood clots a fragment of a second later than it normally would have, leaving an ugly sore.  "Ugly" is the operative word.  Ah, vanity!

The last couple of days haven't been good.  Going out becomes problematic since once the stomach starts growling and cramping, there isn't a lot of time to find a bathroom.  And after several trips in a few hours' time, my energy level sags until I just want to sit or lie and stare blankly at mindless TV (of which, of course, there's no shortage).

Reading is good when my mind is working better.  For the last couple of years, I've read books on my Kindle.  When I retired and was faced with the problem of what to do with the hundreds of books in my office, realizing that there really wasn't space for most of them at home, Mohamed gave me a Kindle.  I thought I might miss holding actual paper and turning pages, but I almost never have; it holds 1500 books (and more can be archived) and takes up no shelf space.  I'd be happy to do a commercial for Kindle.  I did, however, have to add the 'almost' to the sentence before last.  I recently read the Alicia Stallings translation of Lucretius's "De Rerum Natura," or "On the Nature of Things."  The content aligned perfectly with my beliefs: no god, no final cause, the accidental "swerve."  The philosophy is both Epicurean (in the real sense of the term--not hedonism, but reasonable pleasure as the end of life) and, though less directly, Stoic.  There is less philosophy and more cosmology than I had expected; the notion of the swerve, which Stephen Greenblatt's book has made famous, is mentioned really only once, and that in the first book. 

What I found myself focusing on even more than the content (I nodded a lot in agreement) was the translation, which was very widely praised.  Stallings chose to use 14-syllable rhymed couplets, and the Kindle made a mess of the lines, which were too long to fit on one line on the screen, and so were carried over to the next line or two with no consistency in the margins.  That made the reading experience confusing, so perhaps I"m being unfair to Stallings, but I was frequently irritated by her translation, especially her rhyming.  She consistently produced rhymes like 'city' with 'mediocrity,' which isn't a rhyme at all.  With 28 syllables to play with, I thought she could have been more inventive.  Mine is a minority opinion.

Next came three of David Lodge's academic satires: Changing Place, Nice Work, and Small World.  One of the pleasures of teaching at Washburn for so long was that I often got to create one-time courses, and I always wanted to do a seminar about satires of academia (Randall Jarrell's Pictures from  an Institution, Malamud's A New Life, Smiley's Moo--there's no shortage).  I'd read all three Lodge novels a couple of times before, but they all held up again and provided good laughs.  It is, however, probably a good thing that I never did the seminar, since what seems hilarious to someone who has spent 45 years in English departments would probably be mildly humorous for one novel or so to students and then become baffling and dry.

At the moment, I'm re-reading Julian Barnes' Nothing to be Frightened Of, which was the first book I ever read on my Kindle.  It's his mediation on religion and death.  Although I usually like his work a lot, I remember feeling disappointed by the book when I first read it, especially as he was only middle-aged and in good health; his motivation for writing the book seemed strained.  But that was before my cancer, so perhaps I'll have a different perspective on his thoughts now.

Marie-Cecile left yesterday after a short, forty-eight hour visit.  She doesn't seem typically French; if there were a House un-French Activities Committee, she'd be called as a witness.  She's 70, has bright orange hair, and never slows down.  The first time I was ever invited to her house for dinner, she plunked me down in the kitchen, rummaged through the refrigerator, found some leftover pumpkin something, reheated it--and that was dinner.  Among her friends, she's known for other, similar quirks.  Her gift-giving is notorious.  One Christmas, she gave me a washcloth.  As it had a ribbon around it, I thought it was an example of inventive packaging, but no, there was nothing inside.  Another time she gave me one of her father's used (but washed) handkerchiefs and a pamphlet for Catholic schoolchildren.  If it's lying by the door on her way out of the house, it's an appropriate gift.

At her most memorable reveillon for the new year, she gave a large party after having gone through her wine cellar and selected every bottle of wine that she thought had turned or was turning.  Every table had four or five bottles that might still be good.  If guests took a sip and spit it out, it wasn't that they were wine experts; it was yet another undrinkable bottle.  Some tables made it through the whole evening without anything to drink.  You gotta love her, though.  She's always good humored and absolutely indefatigable, and it was wonderful to have even this brief visit with her.  She was in the U.S. with her friend Francoise, whose husband, Etienne, died last year.  I had known both of them somewhat years ago in Metz.  Etienne, like me, had metastasized kidney cancer.  He lived only six months after the diagnosis.  I'm not sure whether I found this news discouraging or encouraging.

I first learned French from a very rich half-French, half-Egyptian woman, Mona, who lived in Topeka.  Her family lived all over the world and thought she was crazy for choosing Topeka, but Mona loved coyotes and wolves, and during the three decades that I knew her, she always had three coyotes, five dogs, and a cage of rescued doves.  In Mona's world, there were two ways of doing things: the French way (as interpreted by Mona) and the wrong way.  Americans who learned French, she always insisted, had to refrain from being informal and using 'tu' and instead always use 'vous.'  She drummed this into me.  When I first met Marie-Cecile's three children, all of them immediately used 'tu' with me.  I was older and a professor; Mona would have cringed.  But once I knew Marie-Cecile, I knew that formality wasn't part of the routine. 

(Mona also taught me say, "Voulez-vous fatiguer la salade?"  The first time I used that phrase in Metz, my friends stared at me as if I'd arrived from another century.  And to digress even further, anytime Mona saw a woman in a store who had a slight mustache or stray hairs on her arm, Mona would say to the stranger, "I notice that you have a slight problem.  I know someone who can take care of all that hair."  When the woman would get angry, Mona would blame it on Americans who can't take the truth, unlike the French (or Mona's version of the French) who are honest about such matters.)

It was great to have my two old French friends in Topeka.  It was also exhausting, and the last 24 hours with Marie-Cecile were not the best of times for me.  Luckily, old friends understand these things.

Frederic is safely back in his small village (population 16) in France, and Marie-Cecile, having spent a week in New York, arrives this afternoon.  Both have been to Topeka before.  In all, 11 Francais have come to Topeka over the years, and I always want to show them what the Midwest has to offer so that when people say, You were in America and went where?!, they'll have something to answer.  I love showing them Kansas City: the Nelson-Atkins, of course, and the Plaza, a drive through Mission Hills so they can see how the 1% of KC live, but also for some of them Worlds of Fun and a Royals game.  The French always protest that they don't understand baseball and won't enjoy it--and then have a great time eating junk food, having some beer, and enjoying the spectacle on a summer night.  And Lawrence: the KU campus, the Spencer, and downtown, which they particularly like because it feels European with people actually walking Mass Ave. instead of driving everywhere.  And Topeka: Washburn, the Capitol (and now once again one can make the scary trip to the top of the dome and walk around outside), the beautiful public library with all its resources and all the people using it.

I used to take everyone to Lindsborg, where we'd stay at the Swedish Inn and then, on Friday night, drive to Brookville, when the hotel and restaurant were still there.  The Garden of Eden was always a bizarre treat, and for the French, the Eisenhower Museum had a special resonance. 

This time, however, the tourism was a lot more limited.  Of course, the point of the visit had changed.  Frederic's lover of twenty years committed suicide early this summer about the same time I was diagnosed with cancer.  Now the point was just to see each other again, to remember good times.  I met both Frederic and Marie-Cecile in 1987, early in my year teaching at the university in Metz.  For twenty years after that I spent every Christmas and New Year's with Frederic and his family.  The two reveillons were celebrated with huge dinners, many hours spent at the table.  Every year his mother, who was in her 80s, and I split three dozen oysters to begin the meal.  There was good food, many laughs, and, of course, champagne and presents at midnight.  The week here with Frederic was good for both of us, I think.

Still, it is frustrating to be so restricted, to have to interrupt each day with a nap, to be exhausted after a mundane excursion like a trip to the library and the grocery store. 

And now it's on to Marie-Cecile, who is 70 (when did all my friends get so old?) but still a bundle of energy.  We're stocked up on wine and have a couple of tins of imported foie gras.  I'm ready.  On y va!

5 or 6 things you should not say to someone who's living with cancer.

Some people who are living with cancer don't like to talk about it.  I heard someone on TV a few days ago who refused to answer questions about her cancer because she didn't want to be defined by her illness.  That's certainly an understandable attitude, though it's not one that I share (or I wouldn't be doing this blog).  I don't think cancer defines me any more than being gay or left-handed does.  But it is significant.  One morning on April 13, 2010, I was living one kind of life; one telephone call later, my whole life had changed.

So, too, I've discovered a variety of responses to my illness.  The most surprising to me are people who I assume know but who say nothing.  Perhaps they don't know.  Should I bring the subject up?  Are they indifferent?  Embarrassed?  At the other extreme, there are those who ask extremely personal questions, which I'll usually answer for close friends.  I'm happiest when people just want to discuss it matter-of-factly and then move on.  I realize, though, that it's often a difficult or awkward position for the other person.  Still, occasionally, there have been people who say things that seem so strange or inappropriate that I have no idea how to respond.  Think of it as adults say the darnedest things--or perhaps as dumb and dumber.  For example,

My dentist after a regular cleaning: "Do we even need to make another appointment?"

The same dentist six months later when I did have another cleaning, explaining why I had to take a massive dose of antibiotics beforehand:  "We're just being overly cautious, but when you kick [his word], it's more impressive if it says 'cancer' and not 'dental hygiene.'"

After the surgery in May, a very nice physical therapist came to the house twice a week.  Once, however, her supervisor came to check on the progress.  She talked for thirty minutes, but didn't do any exercises.  When she was ready to leave, I asked why we hadn't.  She said, "Oh, your prognosis isn't all that great, so I figured you should just enjoy the time you have left."

A secretary (Washburn still uses that designation) with tears in her eyes: "I'm sorry, it's just that you look awful.  You look so much weaker than the last time I saw you."  (If I didn't look awful before--and I wasn't aware that I did--I probably did afterwards.)  The next time I saw her, she was smiling and said, "You look really good."  (Great.  Stop there.)  "You look so much better than the last time I saw you."  (Good.  Let's stop now.)  "The last time you looked like you were at death's door."  (Oh-oh.  Too late.)

Once in a while, I have brunch or dinner with a small group of people with whom I have almost nothing in common; it's a tradition of sorts, though a strange one.  The last time, one guy spent 90 minutes complaining.  When he had the floor, he complained.  When he didn't have the floor, he interrupted everyone else in order to complain some more.  After the meal, he pulled me aside to say, "Since you won't be around to come to my funeral, I just want you to know that I've never been happier in my life."

And finally, at a poetry reading at the university, a student whose mother I've known for a long time said, "I heard about your cancer, but my mom said it's ok.  You had a good life."  A young colleague who was sitting next to me said, "He's still alive, you know!"  But the student was off to spread more cheer.  His comment clearly bothered my friend because that night I got two texts about what he'd said, both including the word 'dumbass.'

A list, as in the last post, isn't satisfying when there's no ending, no completion.  Life is like a list (cue music from Forest Gump). Like all human activities, indeed all natural activities, there is no shape, no meaning without a beginning, a middle, and an ending.  The idea of "eternal life" seems to me not only an oxymoron, but a concept that is unimaginable and, if it could be imagined, undesirable.  "Love calls us to things of this world," wrote Richard Wilbur.  We have them for a while, and knowing that we won't have them forever provides a welcome rhythm to our lives.  So reason #4 for not fearing death is that without that ending, life would have no meaning. 

Steve Jobs, in his search for a spiritual lesson, said that he didn't want to think of life as like a computer with an on/off switch.  It's not the prettiest of metaphors, but, as all of us know from experience, there is that moment when the switch flips to off.  Perhaps more accurately, life is like a rheostat: in the on position, some moments are bright, others dimmer.  I try as best I can to keep the light shining brightly.  One of the frustrating aspects of cancer is that the disease and the chemo and the side effects often dim the lights when I'd like them bright.  Eventually, though, there will be an ending, the switch will descend to the off position:  "Put out the light and then put out the light." 

In my all-time favorite novel, The Sound and the Fury, Jason Compson is fond of cynical descriptions of the cycle of life.  One he does in Latin:  Non fui.  Sum.  Fui.  Non sum.  I was not.  I am.  I was.  I am not.  His cynicism is sometimes amusing, but it's also destructive.  If we think of that series, though, not as something to despair over but as simply the way it is, the sequence suggests the beginning, middle, and ending of our journey.  The world endured for millions of years when I was not; it will endure when I am not. 

. . .

Yesterday was a full day, and by 4 p.m., I was pooped.  Mohamed had homework, and I hated to leave Frederic alone with nothing to do, so I pulled out a bunch of DVDs of French films.  Most were classics (Renoir, Truffaut, Blier) that we had both seen, but one was a French-Candian film, Les Invasions barbares, which I had seen but Frederic had not.  It won the Oscar for best foreign film and is described on the case as a "funny look" at clashing cultures.  The story centers on a university professor who is dying of cancer, and for the first hour, it is funny.  I watched that much with Frederic, but then couldn't stay awake so went upstairs to take a nap (the rheostat was definitely dimmed).  The last part of the movie, however, is not funny, and at the end the professor dies.  When Mohamed came to wake me, he was worried about Frederic, whom he had found sitting in the near dark with no TV, no music, no book, and no mots croises (I can't figure out how to insert accents in this program).  Frederic was beside himself with sadness because of the end of the film and guilt because he had chosen it.  He was convinced that I had stopped watching because I couldn't face the movie's end.  He had a hard time believing that I like the movie and was simply too exhausted to watch the last part.  But I do, and I was.  The movie had its inevitable and natural ending.

Yesterday it was time to go to KC for the results of Friday's tests.  It was our third trip to Kansas City in four days.  Despite the mild winter, the first time there was driving rain (the pun furnished by the cliche), the second time, when we picked up my old friend Frederic who had arrived from France, snow in the air, and the third a very thick fog.  We had to get up at 5:45 so that three of us could get ready to leave at 6:45 for the 8 a.m. appointment.  Dr. Van, as I've said, takes lots of time, so he's always running behind.  Luckily, we were the first of the morning, so he hadn't had a chance to fall behind.  The news was good: the tests showed that the cancer was generally stable.  The primary cancer in the kidney had grown a very small amount; if the growth continues, perhaps I'll have a simple ablation (burning away) of the growth, but generally for Stage IV kidney cancer, since it's already metastasized to other organs, doctors don't bother to remove the tumor or the kidney itself.  The spots in the bones haven't grown, and we'll now reduce the bone-strengthening shots from once a month to once every three months.  There are also spots on the spine and in the lungs, but they too haven't grown.  Looking over the doctor's shoulder, Mohamed could see on the computer that there are small growths on the spleen, gall bladder, and liver, but Dr. Van didn't mention those, and they evidently haven't increased either. It's always a relief to know that everything is stable, and I don't have to go back for six weeks.  Frederic thought the cancer center looked more like a hotel than a medical facilty and was amazed by the joking rapport with the nurse and scheduler.

One characteristic of a university hospital is that there are often interns (residents?) accompanying the physician.  I remember Joseph Heller complaining about this and saying that he'd never go to a training hospital again.  Dr. Templeton, who did the surgery on my femur, had an intern who was, I think, intimidated by her.  When he came alone, he was relaxed and made jokes; when she was with him, he was stiff and sober.  The only times I get impatient with the interns have been when they come before the doctor, ask me what seems like dozens of questions I've already answered, and then return with the physician to repeat the process.  There was an intern with Dr. Van yesterday, but he didn't say a word.  Since there were five of us in the small consultation room, maybe the atmosphere wasn't conducive for questioning, but I was glad I didn't have to feign interest in answering his questions.

It was only 9 a.m. when we finished.  We went to the Plaza and walked around a bit, but nothing was open except Starbuck's, so we had coffee.  Frederic, my French friend, had a croissant, which made him feel at home, and Mohamed had a pastry.  I couldn't eat, since I had just taken the chemotherapy pills, so I just drooled from the sidelines.  On the way home, we stopped at a giant Cabela's--not my favorite store, but I thought it would be interesting for Frederic.  He was duly impressed.  Frederic aime trainer   (he likes to take his time window shopping), and I think he must have looked at half of the thousands of fishing rods in the store, and he loved the aquarium and dioramas.  I worry that he came all this way and that we're not showing him a very lively time, so at least this was a good stop. 

I need to return to and complete my list of the four reasons I don't fear death.  Reason #4 is

We interrupt the enumeration of reasons for a description of yesterday's tests at the Med Center.  Because kidney cancer is relatively rare and because the operation on the femur was complicated, with the exception of the radiation, all my treatments, including the surgery, have been/are at the KU Med Center and the related cancer center, which is located just a few blocks from the main campus.  It's about a 75 minute drive from my house to either facility, most of it on I-70, so it's only slightly inconvenient, and obviously convenience isn't the most important consideration: having the best doctors is.

The original plan for Friday was the regular three month battery of tests (blood work, full skeletal x-ray, CT scan) plus a shot and then a consultation with Dr. Van, the renal oncologist.  But Dr. Van had to reschedule, so that was moved to Monday, convenient because we had a scheduled consult with Dr. Templeton, the orthopedic oncologist on Monday.  By Friday, her scheduler had called to say that she would be out of town on Monday, so that had to be rescheduled as well. 

Friday we got up at 5:45 so that we could leave an hour later and get to our first appointment by 8.  I couldn't eat or drink for four hours before the tests, except for enough water to get down all the pills I take first thing in the morning.  (On a regular day, I have OJ, coffee, and cereal, take the first set of pills, then have to wait three hours without eating before I take the chemotherapy and then have to wait another hour before I can eat.)  The drive to KC was stressful, and there were unusual Februay thunderstorms, heavy rain, and low visibility.  We saw two major accidents, not exactly reassuring.  But we got to the Center with no problems and were called relative quickly for the blood work.  The phlebotomist (written on his lab coat) was not in a good mood.  He seemed to struggle with booting up the computer and getting the correct information and was less than friendly.  When he was ready to draw the blood, I said that when I also have the CT scan and will need an IV, they normally put in a port.  He said there were no instructions to do that; I said it was the way it was usually done.  He repeated that he wasn't going to do it, so I gave up, and he drew the three vials of blood.  Because the shot that Mohamed gives me every morning is an anti-coagulant, it's usually necessary to keep the pressure on the puncture a bit longer than usual.  The lab tech was having none of that either.

Next I registered for the x-ray and the CT scans.  A nurse brought me two bottles of the ionizing drink.  The Center has switched from the "smoothie" to a clear, fruit-flavored liquid in attractive bottles that look like supermarket drinks.  The drinks aren't horrible (the smoothies weren't either), but they're hardly something you would voluntarily pay for.  The nurse told me to start drinking them, but I told her that usually I don't start drinking until after the x-rays because the liquid interferes with accurate x-rays.  This seemed to cause some consternation and several phone calls until I heard one of the staff say, "Oh, here it is.  I found where he's scheduled for full-body x-rays."  By that time, the nurse had told me to go ahead and start drinking, so I had downed one of the bottles.  Now she told me to stop. Luckily, the x-rays went ok (unlike the first technician, the woman doing the x-rays was very friendly), and I could then finish the second bottle and have the CT scan (ditto for the friendliness of the staff).

All this was accomplished ahead of schedule, and we were faced with a two and a half hour break before going to the Cancer Center for a scheduled five-minute shot.  We decided to try our luck there, so we made the short drive and begged for sneaking us in early.  By this time everyone at the Cancer Center knows us, probably because we're an unusual couple: one old and pale and Wasp-ish; the other young and dark and Arab.  And we're both gregarious types who joke around with the staff.  So by 11, we had completed the day's work.  Monday we go back to meet with Dr. Van; two weeks later, we meet with Dr. Templeton.

By this point, I was very hungry, so we met our friend TJ at Stroud's, the famous "home of pan-fried chicken," often mentioned on the Food Network.  The original is in North Kansas City, but there is now a branch near the Cancer Center.  I don't know whether it was not having eaten for 18 hours or feeling relief that the tests were over, but my appetite, which comes and goes, was definitely in full force.  We got a full-order (way too much) of livers and gizzards, the delicious fried chicken, mashed potatoes, green beans, and the best cinnamon rolls I've had in a long time.  I ate and ate.  And I have a great excuse for being a pig: since my appetite is variable, since diarrhea is a major problem, and since it's necessary to keep my weight up, I feel perfectly justified in eating whatever whenever I feel like it.  Sure, there was little that was healthful, and sure, I was completely logy the rest of the day, but rationalization worked as it's supposed to.

Taking all these tests doesn't usually make me apprehensive, but for some reason, this time it did, and I didn't sleep well the night before.  I don't know whether it was lack of sleep or the very heavy meal, but the rest of the day was a blur.  I fell asleep on the way home, I slept after we got home, and I could barely stay awake till 10.  But now it's time for the chemo pills, and then only an after hour of that, I can have the cinnamon roll I brought home from Stroud's.  That sounds like a good plan to me.

Reason #3.  I'm an atheist.  A Muslim friend in Morocco was upset by the subtitle of the blog:  Why did I have to be so aggressive about it?  Was this a guide only for atheists?  (I'm not sure that so far it's even much of a guide.)  In part, the choice was, I'll have to admit, a reaction to a specific event:  I was watching my favorite morning show, "Up" with Chris Hayes.  One of the panelists was a liberal black woman, and I was nodding and agreeing with everything she said when the subject of the death of Christopher Hitchens came up.  The panelist said that she didn't understand why atheists didn't just shut up and stop being so in-your-face about their lack of belief.  She was a Christian, and Jesus was...  On and on she went, and higher and higher went my blood pressure.  She didn't see any reason why she shouldn't expound on her beliefs, but those atheists! 

Many people have said, "I'll pray for you," and that's fine with me.  I know the intentions are good, and we atheists don't have much that's equivalent.  "I'm sending you good thoughts (or vibes or whatever)" isn't very powerful.  But I've also gotten, "Christ is the Great Physician.  You just have surrender yourself to Him" and "Disease isn't real.  You can will illness away," and then my response isn't quite so generous.

God, prayer, spirituality, heaven, hell--all are absolutely empty concepts to me.  They have no purchase, either emotionally or intellectually.  And I find that very comforting.  One of Stephen Crane's short poems reads
                                 A man said to the universe
                                 "Sir, I exist!"
                                 "However," replied the universe,
                                 "The fact has not created in me
                                 "A sense of obligation."
The speaker addresses the universe very politely.  With "Sir," he affirms his respect.  He's succinct: a simple subject and a verb.  He makes no demands, but simply states a fact.  (Perhaps he's thinking of St. Augustine's I want you to be.)  True, he ends his statement with an exclamation point, the only indication that his emotions are more intense that the content of his remark suggests.  And the universe responds with flat indifference.  Crane was a PK, a preacher's kid, and there is a certain reactive bitterness in this poem, as in most of his work.  For me, though, it what the universe says it is: a fact.  It is what it is, and that's that.

Without God, the supposed stages of grieving can be ignored entirely.  Anger?  There's no one/nothing to be angry with.  Bargaining?  Ditto.  There's no fruitless asking "Why me?"  No one will answer, and no answer would make sense. 

Life takes meaning from its shape, and the idea of hell and even more so of heaven are beyond my ken.  As in so many things religious, Twain got it exactly and hilariously right.  What would eternal life even mean?  As Wallace Stevens says in one of the most beautiful poems of the 20th century, "Sunday Morning,"
                                 Is there no change of death in paradise?
                                 Does ripe fruit never fall?  Or do the boughs
                                 Hang always heavy in that perfect sky.
                                                     . . .
                                 Alas, that they should wear our colors there

As Stevens writes in an earlier stanza, if the earth is all of paradise that we know
                                 The sky will be much friendlier then than now,
                                 A part of labor and a part of pain,
                                 And next in glory to enduring love,
                                 Not this dividing and indifferent blue.

Amen!

On a different topic, tomorrow I go to the KU Med Center for a day of testing.  Every third month, it's the complete battery: first blood work, the a full-body x-ray, then, after drinking two bottles of "creamy vanilla smoothie" (a/k/a barium), a CT scan.  Then there's a break, followed by the $11,700 bone-strengthening shot (the price went up $500 with the new year).  The primary kidney cancer hasn't been growing, nor have I had any symptoms of kidney cancer.  On the other hand, the metathesis to the bones has been very aggressive.  Here's hoping that the expensive shot is doing its work.  On Saturday, my oldest French friend is coming for a visit, and we're looking forward to a week of good food and wine and French conversation.  And then on Monday, it's another trip back to the cancer center for consultations with both the orthopedic and the renal oncologists.  Some of this schedule sounds more fun than the rest.