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Wednesday, June 23, 2010

Dancing with the Demons of Mind

The last few weeks have been an emotional whirlwind, bouncing from utter fear, to anger, to resentment, to resignation and philosophical acceptance, and back and forth between these poles like a billiard ball. Worst of all is the not-knowing – do I have cancer or not – and with that question the mind projects all the possible scenarios, and the captive audience of one gets to enjoy the whole circus. And it’s everything but dull, and you begin to re-appreciate times of boredom and ordinary dullness.

I would never usually begin with, “It all began,” but it all began about six months ago when I got some lousy numbers on a PSA test. For those who don’t know, as I didn’t, PSA stands for Prostate-Specific Antigen blood test, and any PSA value higher than 4 usually indicates an enlarged prostate gland and about a 50% probability of having cancer. An enlarged prostate in men over 60 is not unusual at all, but if a doctor, a competent one, sees a number greater than 4 in your PSA blood test it’s a warning flag. Interestingly the medical profession has lowered that base number from 4 to 2.5. My local GP, spotting a number of 4.65 advised I see a specialist and get a second PSA as well; both of which I did.

The second PSA doesn’t look any better and I’m not freaking out or anything, but it’s got my attention. So off I trot to Dr. X, who looks like a kid to me, but then again anybody under 50 looks like a kid to me, and he checks me out. I’ll spare you the details. He gives me what I presume to be the standard tutorial about prostate health, what the numbers can mean, operative word being can, and based on this info I decide to let things go for about six months, get another PSA then and see where things are at. Dr. Kid concurs and off we go to our separate lives.

So for the next six months my mind is noodling with thoughts of life and death, and all the things I’ve not done, not seen, not accomplished and other such titillating conjectures, but it’s not a full time occupation and I get on with the tasks of the day.

Time passes – cut to fluttering calendar pages – and it’s off for another PSA. Numbers higher. It’s now in the 5s. Another meet-up with young Dr. X. We agree that the only way to find out what’s really going on is taking the next step – a biopsy. He gives me all the medical particulars and I tell him I’ll give him my decision in a couple of days; all the while thinking, I want a second opinion.

One thing needs to be said at this point. I’m not going to reveal the outcome of this story until it’s necessary so that the reader can experience a taste of the aforementioned ‘not-knowing’ as did the writer. Makes for better drama, anyway.

Local primary Doc agrees about second opinion and sets me up with a “hot shot” in Marin. Dr. Hot Shot gives me the once over, not the most engaging of fellows, making me feel more predisposed toward Dr. Kid, and agrees with prognosis to get a biopsy. Okay, thinks I, the dye is cast. I schedule one with Dr. kid: he’s my guy – I’m going with him. He looks at you when he’s talking to you and listening to you.

Now the worry barometer kicks into high gear. There’s the fear of the biopsy – the fear of the pain. Always an attention graber. Then there’s the fear of the outcome, the great, existential door-prize, which I’m becoming convinced is my immediate fate, along with Dennis Hopper, not someone I’d buddy up with going across the great divide, but one doesn’t get to choose in such matters. Now, as they say, the mind is focused, and oh how I’d like some mind-bendingly boring ordinariness,

When you can set aside the palpable fear of the biopsy procedure for maybe a few minutes with the news on TV, the pageantry of national and global misery, or get caught up with the blessed relief of kitchen remodel work, there’s still the underlying dialogue in your mind about your death, you’re no-moreness. It seems almost unbelievable. You’ve always been you, ever since you can remember. How can that just disappear? Cease to be? Stupid thoughts, but up they come anyway.

And then how do you handle the whole thing? How do you play it out? I’ve got to be brave about this, I tell myself. I have to handle this with dignity, courage and mature resolution. But I’m scared shitless, I confess to myself. Get over it, you pussy, I slap myself straight. And then there’s the wheelbarrows of self-pity. It’s not fair, everybody is living much longer than 69, 70. My dad made it to 86, as if it’s a scorecard, and goddamn it, it is.

Around and around, sleepless nights, visiting every room of the internal lunatic asylum like Dr. Demento on rounds. All the usual distractions come and go, but under cover or lurking behind the next corner is the worry-demon, ready to pounce. And numero-uno on the top 10-worry list is the biopsy. Just the word is enough to conjure nightmares.

So, comes Biop-day, and I, now known as the patient, ride off to Petaluma for a new experience, which in and of itself turns out not to be a big deal. In fact it’s a small deal, not painful, nor a barrel of laughs either, and lasts less than a half-hour.

Dr. Kid and I exchange pleasantries. I call him by his first name and invite him to do same. After all, I figure if he’s going to be mucking around my innards we should be on a first name basis. He’s very patient with his visibly nervous patient, and a snip here and a snip there, and one is back in the car and headed home.

Now comes numero-two-o on the worry barometer, far surpassing the easily handled biopsy number. Now comes all the possible results, from get your affairs in order to a litany of chemical and nuke treatments, and all the surgical stops between. My mind, a labyrinth of things to worry about that I’ve long wandered, hardly ever dares entertain positive outcomes. Maybe it’s just habit or simple superstition, but I’ve never been one to accentuate the positive.

I won’t get an answer until Friday so there’s ample time to endlessly review how the bad news is going to be broken, which kicks off scenario-like coming attractions of how I’m going to deal with it. Brave, courageous and bold, or sniveling, complaining, pitiable whelp? Or both for that matter. There’s no dearth of possible melodramas to consider that all end with the demise of my favorite character in the play. Call me narcissistic, but I’ve grown used to me over the years, and I like my life and I’m not ready to exit the stage.

Okay then, Friday rolls around and it’s meeting time with Dr. Kid for results. Short wait in office in local hospital, escorted into a private room, and before I have time to read the same line in some newspaper story more than a few times in comes young Doc. And he’s smiling. A good sign, my inner genius notes. “Good news,” says he, or something to that effect, “there’s no cancer.” He goes on to give me some other happy medical data, but I’m not really hearing the details. I heard what I wanted to hear and the rest are throwaway lines. I note young Doc looks sincerely happy and I like him all the more.

“Do you mind if I let out a war-whoop?” I ask him. He smiles uncertainly, but nods agreement. I let one go; hospital or no hospital. I’ve been doing a from the gut, from the soul, really loud whoop when overcome with exceedingly great moments of joy in life for years now. There are times, not many, when it’s the only thing one can say.

No moral to this tale, nor wisdom gained or newfound understanding of the curious state of being alive, in a body, inexorably decaying and a consciousness that keeps you aware of all the disparate things that are happening to something you call yourself. And you go about living it out day by day, hour by hour, worrying, rejoicing, getting angry, sad and disappointed, as well as laughing and crying. And all in all very thankful that you get a chance to keep doing it for a while longer.