There are special moments that come along ever so rarely, where the only reaction I can muster is : wow.

Last Saturday was one of those moments. A friend of ours, a brilliant writer, had finally succumbed to cancer after a brave 10 year battle. Her funeral was a testament to her courage, her love for others and her wordsmith ability.

When her eldest son stepped on the stage to deliver his eulogy, I did not expect what came out of his mouth. He painted a moving, heart-wrenching portrait of his relationship with his mother, her life and his feelings through the long storm. He wrote and delivered in a sublime way what I thought indescribable.

And to say that it hit home is a gross understatement.

I give you Phil Cotnoir's eulogy. Thank you Phil for making me feel your feelings, for accepting the doubt, for falling on your faith, for letting me peer into your mind and for bringing me along on your journey. 

You are beyond talented, like your mother. Again: Wow.
 
 
It seems to be all around me. I don't know if it's because I am getting older and more aware, or if it's because there are more cases of it, or that I've just been 'unlucky' to have had more contact with it recently.

My wife had it two years ago and is in remission. My mom just got operated and had it taken out. My friend's mom just passed away because of it. The couple who my kids adopted as their third set of grandparents both got diagnosed with it. A close friend of my father (and the man who married my wife and I) will soon lose his wife to it.

It is an insidously spreading, often-don't know-you-have-it-until-it's-too-late, never-sure-if-it's-gone, playing-the-odds disease.

And the more I ponder on cancer and its treatement, the more I see it as a paradox. Here's how:
- It is the only illness that the treatment (chemo) is actually worse than the disease itself
- It is really just too much of a good thing (cells proliferate too much)
- It is the treatment's goal to kill everything good to make sure it gets all the bad
- Everybody has varying degrees of it
- When one has it, it seems everyone has a thought about what we should do, and most have no idea what they are talking about
- Scanning for it too often may actually provoke it
- Once you're done the treatment, there is a sword of Damocles for years hanging over one's head
- We know next-to-nothing about it. We are still learning, it's not an exact science, and it keeps us humble

There is, however, something beautiful I have discovered when you are a part of those affected by it. When you talk to patients and survivors, to the cancer community, there are no pretentions, no masks, no hypocrisy. What you see truly is what you get. I desperately wish is that we could extend this openness and honesty to everyone without the necessity of going through a horrible cancer.

xkcd brilliantly put his own learnings on cancer in the cartoon below or here.
Picture
 
 


Let me tell you a story.

It all started with a little blood in the stool on thursday february 5th, 2009. The next day, there was a little more. And in the night of friday to saturday, my wife was quietly hemorraging. I say quietly because when I woke up saturday, she told me that she had a little more blood in the stool and was going to the local clinic just to be sure (we later found out she had lost close to half of the red blood cell count).

After 4 hours at the clinic, the attending doctor was not alarmed. He told her to go home and eventually take an appointment with a gastro-enterologist, which, he warned, could take months. So back home, Saturday noon, she was debating whether to go to the hospital or just 'walk it off'. A wise phone call to her eldest sister, a pediatrician, convinced her make the trip to the emergency room. So she drove there (remember, she unknowingly only had half her blood) while I was home with the 3 boys.

As soon as she stepped in the ER, she was placed as a priority case (the advantages of a rural hospital). They started monitoring her and booking her for tests to find the cause of the bleeding. By the evening, they had sent a camera down to the stomach to find out if there were ulcers to burn - but to no avail. So they booked her for a colonoscopy Sunday morning with her Saturday night filled with drinking a disgusting Gatorade-like juice to empty the system out. At that time, we were pretty sure it was an ulcer somewhere that just needed to be burnt with the camera light. An annoyance more than anything else, or so we thought.

Ah, Sunday. A day drilled into my memory banks. It was her father's birthday too. The colonoscopy was done before noon and then there was an interminable waiting period in the ER. It seemed like an eternity not knowing what the problem was, hoping for a small ulcer, being told to wait 'just a little longer, you're going to the 4th floor, oh no wait, you are being transferred to the 7th floor'. And for an alpha male like me, those 7 hours were a brutal test of patience.

We finally got transferred to a room on the 7th floor, with other people who have been operated on. Hummm ok. So that means she'll get operated on ? Why ? Don't they just burn ulcers with the camera light ? And why were the nursing personnel coming in to see us every 5 minutes ? Finally, around 9pm, the surgeon walked into the room and, after sending everyone out of the room, sat beside me at my wife's bedside.

Looking down, she got right to it: 'We performed a colonoscopy to go see what was in your colon and the reason why you were bleeding through the stool. What I have to tell you is not going to be good news. It actually quite bad. We found a growth in the colon and we are pretty sure it's cancer. We think you have colon cancer.'

Ouch.

A million questions went through our minds. What ? How ? Are you sure ? How bad is it ? What happens now ? ... and the big one ... What about the kids, what will happen to them ?

After a couple of my feeble and inept attempts to reassure her that everything would be OK - I didn't believe my own words - the surgeon went on to say that the operation would be early next morning and they were going to take out the piece of the colon with the tumor. It was all happening too fast. And this was the worst news we had ever gotten, and the closest we felt to death.

We called her parents and mine and a few close friends. More tears were shed. Some prayed with us, well they prayed and I listened, crying, broken. That night, I left the hospital to let her sleep before the operation, but we both didn't get much rest. I went from breaking out in tears to convincing myself that God was in control to praying for this nightmare to end and then back again to the tears.

As much as I prided myself on being someone who has accomplished much, none of that mattered. I wasn't in control. I was forced to rely on my faith and others. And it hurt.

The operation the next morning went well. During the operation, I was reading up on colon cancer and I found out that there were 12 risk factors... and that my wife had none of them. This was out of left field. So they took out the tumor and a piece of the colon, they reattached it to the small intestine. Then they confirmed through initial pathology that it was a malignant tumor and that there was a distinct possibility that there was a proliferation of the cancer in the body. More tests had to be done to determine the depth of the tumor and if any ganglion were hit. And the word 'chemotherapy' was mentioned as a possibility for the first time.

Ouch.

Then the support system started to react. More on this later, but suffice to say it was quite a challenge to manage the different reactions to my wife's cancer.

When I arrived Thursday morning to see her, they had moved her from room she was in to a quarantined one with gloves, masks and med coats at the door. What ? Why ? Well sir, they said, she has contracted a highly contagious bacteria during the operation - so we need to quarantine her and you need to dress up to go see her.

Ouch.

She left the hospital on Friday with antibiotics for the bacteria and staples on her scar but in great spirits. She was finally going to see the kids after an unexpected 6 days in the hospital. They needed to see her as much as she needed to see them.

We needed to wait 3 weeks before getting the full pathology results on the cancer. Longest 3 weeks of my life. I'm not very good at waiting so this was another brutal test of patience and faith. Finally, the oncologist tells us that the tumor was indeed malignant and a stage 4 one at that (out of 4) because it was at the colon wall and that the next step was out of the colon into the liver and the lungs. Good news though, there were no ganglion found out the 19 that were tested. He then entered the variables into a software (age, type of cancer, etc) and outputs 2 scenarios: one with chemo and another without. 'Basically without chemotherapy, he said to my wife, you have a 25 % chance to get cancer again in the next 5 years. And this time it won't be in the colon but in the lungs and the liver with palliative chemo treatments. With chemo, he goes on, you're chances fall to 15 % so you gain 10 % in your risk management for 6 months and 12 treatments of preventative chemo at the rate of one every two weeks for 3 days at a time. '

It didn't take us long to decide. We wanted to be able to say we did everything in our power to beat the cancer as best we knew how.

I had a revelation the first time we walked into the cancer-patients waiting room. Picture a room packed with older people with no hair and bandannas on their heads, most in wheelchairs, chatting, sharing and smiling. On the walls of this room, there were posters plastered everywhere about help support groups and phone numbers to call. And then it hit us - hard. This was us, these were our peers. We had instant solidarity with a group of strangers with similar worries and fears but also with similar dreams and hope. This was a fraternity, a microcosm of understanding and courage.

In the midst this whole experience, one piece of advice stuck out for me. It came from a two-time chemo patient who was sharing her experience with me. She said: 'God gives me and renews His grace and His strength one day at a time, not more, not less. So I every morning I wait on Him and every night I thank Him.' For a control freak like me, it was an earth-shattering statement.

Yesterday was her third treatment - 2 months after we first found out about the cancer. We now know that she lives the full force of the side-effects one week out of two. And we've adapted, and we're helping the kids adapt too. And our priorities have radically changed. I am now more at home and I do what my wife spent years compensating for what I should have done. I've had to quit many extra-curricular activities that have defined me in the past, like the Entrepreneurs' Organization, church and community activities.

Throughout this whole ordeal, my wife demonstrated a calm, a quiet strength, an integrity-filled character and courage that could shame the Wizard of Oz's lion. And, true to her sensitive self, I would often find her comforting others who had trouble dealing with her own cancer. I know...

Oh, and I have half a mind to call back the incompetent attending doctor at the local clinic.

--- THANK YOU ---
I'm grateful for so many things in the last 2 months and seeing these silver linings in the very black clouds was quite salutary.
- The blood in the stool as a sign was a rare and surprising occurrence.
- It was caught early, right before it hit the ganglion and the liver. It didn't splash to other organs.
- The operation went well and the intestinal reconnect too. She didn't have a stomach bag.
- It's in the colon, a body part we have a lot of.
- Her attitude is tops.
- She has 5 sisters and we have a fantastic family and friend support system. We truly felt the prayers done on our behalf and thoughts that were sent our way.
- The kids are awesome and have adapted well
- It didn't happen while she was pregnant. We would've lost the child or had to provoke her
- And finally, I am thankful for all the lessons learnt, the first of which was to learn 'to be thankful'. ;)

--- FRIENDSHIP ---
I learnt a lot about ways to react to this type of news through hundreds of different reactions. For me, the below reactions show true genuine friendship. These golden people :
- listen first and foremost... and talk a lot later
- don't look to offer grandiose solutions, because there aren't any
- are genuinely interested and worried about how we are, not just what we are going through
- don't think of themselves
- are proactive and creative about ways to help and encourage us
- don't preach to us or look to interpret for us the 'why' this is all happening
- are sensitive to our basic needs (like food, time, kids, mental health, morale, etc.)
- are just there.

This poem came back to me a couple of weeks ago. I had it in a quaint little book called Treasury of Inspiration that got me through some tough times in the past. It really defines the type of friendship that I appreciated.

'When trouble comes your soul to try,
You love the friend who just "stands by."
Perhaps there's nothing he can do --
The thing is strictly up to you;
For there are troubles all your own,
And paths the soul must tread alone;
Times when love cannot smooth the road
Nor friendship lift the heavy load,
But just to know you have a friend
who will "stand by" until the end,
whose sympathy through all endures,
Whose warm handclasp is always yours--
It helps, someway to pull you through,
Although there's nothing he can do.
and so with fervent heart you cry,
"God bless the friend who just 'stands by'!" '

Written by B.Y Williams, published in Poems That Touch The Heart by A.L. Alexander

--- MY OTHER LESSONS ---
There are so many things that I realized since that dreaded diagnostic. I must admit they were almost all ego-destroying lessons.

*Fair warning, many of these lessons are biased by my Bible-based world view.

- Anything can happen to Anybody, Anytime, Anywhere so essentially, my life is not my own (try telling that to an entrepreneur).
- No man is an island, I need help and need to learn to accept it.
- When I lost everything, all that was left was 1. Love from God and others, 2. Faith in His Word, His plan, my beliefs and my values and 3. Hope in a better tomorrow.
- The most powerful force on Earth is the collective, focused prayers of God's children.
- The theory of suffering is worth very little until it is fully experienced.
- God never promised me healing, or an explanation. He just promised His presence - and we have felt it.
- Life is so short, so we will live it up and only do things that stick to my core value with people that are fit with us.

--- CONCLUSION ---
I wrote this for you to know what transpired in the last 2 months. But in all honesty, I write this post mainly for me. It's therapeutic for me to put on (virtual) paper the fruit of this whole experience. It's not over, but at least now I know more of what I'm looking at... and whose looking at it with me.

--- COLON CANCER ---
Here is some general info on this type of cancer
- Wikipedia entry: Colorectal cancer