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Warren Graham's Blog: 04/26/06

Postings by Warren on a variety of timely and (hopefully) interesting topics

Wednesday, April 26, 2006

Microhistory: B.C. to A.D.

Inordinately fond of history as I am, I’ve decided to write about it. Not about my first love--from an historical perspective, I mean--Medieval European History, or my second love, Russian History. Not even about the bloodiest day in American History, the Civil War Battle of Antietam, which should have brought the Union cause close to victory, but, due to incomprehensible blundering, ended in a strategic draw, breathing two more years of life, at least, into Lee’s Army of Northern Virginia. No, the history I want to write about is microhistory, i.e., MY history. Specifically, I wish to analyze, evaluate and discuss my recent struggle with cancer, and its meaning and consequences, if such may be found in that experience.

The B.C. to which the title refers is Before Cancer (or Before Chemo, if you like) and the A.D. stands for After Deconstruction. Those concepts and their respective meanings will take up the bulk of this essay.

But first, the salient facts: on February 28, 2005, just after my family’s return from a ski trip in Lake Tahoe, I woke up at about 2:00 a.m. with an unstoppable case of the hiccups, followed by an attack of almost unbearable abdominal pain. An ambulance took me to the emergency room at Lenox Hill Hospital, where the doctors diagnosed a “perforation or hole in my stomach,” perhaps caused by an ulcer. They needed to operate immediately in order to save my life, but hoped that the surgery could be done laproscopically, so as to be minimally invasive. As the anesthesia was administered (for which I was deeply grateful), I could not have known that everything up to that point was, for me, B.C.

A day or two later (my memory is still somewhat hazy on the chronology of this period), when I was still heavily drugged, but able to speak and concentrate, I was told what the rest of my family already knew: that I had a poorly differentiated stomach cancer, known as linitus plastica, a cancer which, oddly enough, is more common in the young, and most prevalent in Japan. The cancer had been removed, as had my lymph nodes, and the lab testing was underway, with the results to be forthcoming in a few days. Just a few years earlier, my beloved father-in-law had died of stomach cancer, so I suppose I could be forgiven for some lack of optimism at that moment.

My recovery from the surgery (which was not only non-laproscopic, but required, in fact, the removal of every millimeter of my stomach, and the attachment of my esophagus directly to my intestines) was surprisingly quick and quite satisfactory, but as I was about to be discharged from the Hospital, my surgeon informed me that the lab work had confirmed his worst fears: that the cancer had infiltrated my lymph nodes and that, although he had removed all of them, the chances of metasticization were great. He informed me that my life expectancy without treatment was about three months, and that, with aggressive treatment, I might make it for as much as two years (although he had rarely seen that). In so many words, he suggested that I put my affairs in order and prepare myself emotionally for the journey from which there is no return (with all due respect to my believing Christian brethren, even He whom they believe DID return, stayed only for a short visit).

This conversation with my surgeon marked the beginning of my A.D. experience. It is an experience, I expect, more or less common to anyone who has been told that he or she has a fatal disease, and it forces one to contemplate not only death (indeed, for me, that was the easy part), but more importantly, a world and a future, in which he or she will have no part. Suddenly, and without warning, I found myself crying. Not about dying. Not about suffering. Somehow, those things did not seem real, or tangible, or even important to me. But rather, what I found devastating was the prospect of not being able to visit colleges with my younger daughter, as I had done with my older one; of not being able to dance (and, as importantly for me, to pontificate) at my daughters’ weddings; of not being able to attend my nephew’s Bar Mitzvah in Israel (then ten months in the future). And finally, of not being able to visit all those places all over the world which my wife and I had promised one another we would get to someday.

All of these considerations are deconstructing, to be sure. The prospects I mentioned were daunting to face, but, oddly enough, strangely liberating at the same time. Everyone…my friends, family, colleagues and law partners told me not to worry about anything, other than getting well. I seized onto that and instantly felt freed from the shackles of my career, the need to pursue professional success and earn money (I was, later on, to pay dearly for this extended holiday from reality). My wife and I, together with my brother-in-law, who had (God bless him) flown in from Israel at the drop of a hat and a few close friends, had begun some surreal discussions of emergency estate planning, including the desirability of an immediate sale of our home, the creation of various insurance trusts, and the like. My older daughter had been asked to fly home from college without being told why. My younger daughter, not generally being given to displays of emotion had, I was told, been crying into her pillow for several nights straight. My wife put up a brave front—she is, after all, an Israeli—but was plainly devastated. The rest of my family members, my mother, brother, sister, aunt, cousins, together with my family, by marriage, in Israel and their respective families, reacted as one would expect: with varying degrees of worry, disbelief and fear.

In the meantime, I was, mercifully, functioning on a copious supply of opiates, to deaden the post-surgical pain. It worked some benefit on my psychic pain, as well, and I was able, through the haze, to become inured to the idea that I was about to embark upon a fight for my life in which, it seemed at the time, I was unlikely to prevail.

People visited me both at the hospital, and later, during my convalescence at home, in droves. I simply do not know how I could have coped without the support of my family and friends, both here and in Israel, and in particular, the support of friends and people whom I took to be mere acquaintances from my synagogue, Kehilath Jeshurun, in New York, together with its professional staff of Rabbis and others who visited, called, wrote and prayed for me. Cousins in Chicago sent out e-mails to their yeshiva friends to put my Hebrew name on their mi-shebeirach (prayer for the sick) list, and my daughter’s Chabad Rabbi in Buffalo, together with my own Rabbi in New York, Haskel Lookstein, still pray for me regularly. I cannot even imagine how anyone gets through an experience like this alone, yet I know that people do. Part of the deconstructing experience was the realization, not only of how much I meant to people, in a way of which I was completely unaware, but of how much they meant, and still mean, to me. The support of this myriad of people has had a salutary effect on me, in that I try to take friends and family less for granted.

After much research, both by me, and by friends and family members, I began to interview oncologists, and narrowed the field down to two. Both reviewed my files and ran tests on me and, to my surprise, and immeasurable relief, advised me of their strong disagreement with my surgeon’s prognosis. They agreed that, although my type of cancer was serious and, indeed, life-threatening, the surgery, coupled with an aggressive treatment of chemotherapy and radiation gave me good reason to hope for a complete recovery. After deconstruction comes reconstruction. I underwent the recommended treatments, and, 14 months A.D., am, as far as my tests can determine, cancer-free. I attended my nephew’s Bar Mitzvah in Israel this past January, and have taken my daughter to various college visits. As to whether I will dance at my daughters’ weddings, or take the “Grand Tour” of the World with my wife, well, that’s very much in God’s hands, on a great many levels. I do not, and cannot know whether I have beaten this thing, but I do know that if there is more adversity to come from this disease, that I mean to go down fighting.

The difficulty now, lies not only in being vigilant about a return of my disease. That is, of course, self-evident. The trick is to take from this experience the lessons it has afforded me about priorities, and to live those lessons. Easier said than done. The path of least resistance, of course, now that the immediate threat has receded, is to go back to old patterns of B.C. thinking, which focused on making money and engaging in material pursuits: A nice house, nice car, nice clothes, expensive vacations, etc. My personal relationships, B.C. were certainly important to me, but as much (I am somewhat embarrassed to say) out of a chronic and childish need to be loved, admired and approved of, as out of more altruistic motivations. A.D., I still like nice material things. If anything, I am now more interested in nice clothing as, at 165 lbs., (80 lbs. less than my all-time high) I have the physical attributes to look much better than before in off-the-rack outfits. But I would like to think that my love of things material is somewhat more in perspective now. I approach those desires more in a carpe diem sort of way, than as goals in and of themselves. As for my personal relationships, I try to appreciate my family and friends more. I do not always succeed, as my wife, above all, will attest to. Reconstruction, after all, (particularly MY reconstruction) is very much a “work in progress.” But I keep in touch (e-mail makes that extremely easy), and have grown much closer to some people whom I have known for most of my life. I find myself in the synagogue on a daily basis. Many around me don’t understand what they see as something of an obsession, but for me, it suffices that I understand; I NEED to have a daily conversation with the Almighty, both to thank him for my recovery to date, and to ask for its continuation. Moreover, it is a mechanism for seeking the well-being of my family, my friends, the Jewish People, my Country, the State of Israel and humankind, all of which have now seemingly become infinitely more important to me. I don’t know of anywhere else where one can hope (or dare) to place so tall an order.

I am working hard to rebuild my professional life. My illness and resultant inability (or unwillingness) to focus much on being a lawyer for the better part of Year 1, A.D., cost me, and I need to redouble my efforts just to get back to where I was. I mean to do that, and quite a bit more. Luckily, I have recently joined a firm, in which a number of the partners are old friends, supportive, professional, and understanding. I have no doubt that I will land on my feet. Also, luckily, I am very good (I apologize for the immodesty, but this is truth time) at what I do. My clients, and potential clients will be well-served by me, and will be lucky to have me representing them.

So, can cancer actually be good for you? It seems a flippant, and ultimately, perhaps, a stupid question. But the answer, I think, is that it can be, provided, of course, that it’s the kind you can recover from. That’s obvious. What is less obvious is the beneficial qualities of the lesson or lessons one can take from such an experience. I can attest, of course, only to my own experiences. I now celebrate a second “birthday” on February 28, the dividing line between B.C. and A.D.

Even the most fleeting glimpse of the Angel of Death can teach us something about priorities, if we are observant enough to learn the lesson, and are wise enough to “walk the walk” on an ongoing basis. May God grant me both the strength and the perspective.

Warren R. Graham

Copyright 2006