deathwish

Last week, Nicholas Kristof wrote in the New York Times about his recent cancer scare and how it improved his outlook on life: “A brush with mortality turns out to be the best way to appreciate how blue the sky is, how sensuous grass feels underfoot, how melodious kids’ voices are.”

This has not been my experience.

Maybe it’s because Kristof’s test turned out negative, whereas I actually have cancer, but I think it’s due more to the fact that I appreciated life sufficiently before my diagnosis, thank you very much. I mean, I’m not a moron; I read books; I have an imagination; I know that even with cancer my life is more privileged than 99.99% of humanity’s. So while Kristof is fondling the grass with his insteps, I’ve just been staggering around, gobsmacked.

I should state up front that this disease, a relatively rare (I prefer “elite”) type of cancer called medullary thyroid cancer, is not immediately life-threatening. There are roughly four types of thyroid cancer. Anaplastic is a death sentence. Papillary and follicular are more or less “cancer vacations”: they are highly curable and, because treatment involves radioiodine, rendering you a biohazard to those around you, sufferers often spend a week in a hotel during recovery, ordering room service and watching round-the-clock pay-per-view.

Medullary is somewhere between the two. It metastasizes quickly to the lymph nodes around the neck, but progresses indolently from there. Thus, surgery is the standard of care, and chemo and radiation are given only in advanced cases. Radioiodine doesn’t work, because technically it’s the C cells, not the thyroid cells, that are affected. There are a few biomarkers that give an indication of how far the disease has progressed. In my case, it does not seem to have progressed very far.

It was discovered during a routine physical by my new primary care physician. I had switched doctors because of a persistent cough that homeopathic guy wasn’t helping to solve, and the new doctor found the nodule the first time she saw me. On Wednesday, I’m having a total thyroidectomy and “modified radical neck dissection” (isn’t “modified radical” an oxymoron? And will they put my neck back together after they dissect it?). After that, there’s little to do but measure the biomarkers in my blood and be on the alert for new metastases which, with any luck, could never occur.

I shared the news only with a few close friends early on. One friend, wanting to inquire discreetly about my health in front of other people who didn’t know the story, asked me, “How’s your little project going?” For some reason, that just cracks me up. My project is doing very well, thanks for asking! We’re on time, under budget, and hitting our quality targets! Just don’t use the term “deadline”!

Since then, that’s how it’s struck me: Not as a goad to more contemplative living, but as an unwanted project draining time and resources while I’m still expected to do all the rest of my work — you know, the kind I get paid for.

Or, to use another analogy: Since I got the initial diagnosis from the endocrinologist (over the phone, during a meeting with my manager and VP, after which I had to give a presentation), I’ve felt like a computer running an extra program. On my desktop are all the usual applications: commute, kids, breakfast, work, lunch, work, commute, kids, dinner, and so on. But in the background the “cancer app” is weighing all the various cancer-specific alternatives to whatever is being discussed in the foreground. Vacation plans: Will I need to reschedule them? An off-site meeting in July: Will I be able to drive by then? A new assignment: Will I be heading into a second surgery by the time it hits?

In the morning, it doesn’t bother me too much. By the time I get into the car at the end of the day, though, I feel like the cancer program has sucked up all my CPU. Every day at sundown, I crash, and I don’t know why I’m having such a hard time with this. Physically, I feel wonderful, and I expect to recover quickly. Mentally, I want to stop the world, but it just keeps going ’round in its orbit, and I’m resentful as hell. I don’t know what’s worse: being sick, or being angry at myself for not handling it all better.

You know, as a kid, I was a huge fan of all those terminal illness stories. Remember Eric? Death be Not Proud? A Summer to Die? (If every time you get a nosebleed, you think “cancer,” then you’ve probably read one or more of these books.) I always thought that if I became a tragic heroine, I’d be a lot more heroic.