One year ends, another begins
I often think that if I were in Jim’s shoes, I would be insane by now.
It’s not just the holidays or the passing of one year into the next. Those are standout days, sure, ones that most Americans stop and acknowledge. Landmark days must particularly resonate for Jim, who’s wondering if he’ll be around to see another Thanksgiving, birthday or Christmas.
But those aren’t the days that would drive me mad (or at least, I don’t think they are). What would get to me would be the myriad inconveniences and frustrations of typical days. Not only would I be mourning the passing of each day (”This may be my final Dec. 29 ever. I may never see this calendar day again.”), but I’d also be grieving each wasted second spent stopped at a red light, standing in line at a grocery store or waiting for a table at a restaurant. Even though I don’t know how much time I have left in my life, I’m impatient. If I knew I was dying, I think I’d be far worse.
How do you think you’d react?
Merry Christmas, everyone!
I know it’s a couple days early for this post, but I just wanted to wish everyone a great Christmas and a happy New Year — especially the Chastains.
My Christmas wish is that they’ll be able to spend Christmas 2009 together. Jim thinks things will be pretty grim for him by May. Every time he mentions that, I find myself thinking of the old Frank Sinatra song, “Pocket Full of Miracles.”
“I hear sleigh bells ringing
Smack in the middle of May.
I go around, like there’s snow around.
I feel so good it’s Christmas every day.
Lee-ife’s a carousel. Fee-ar as I can tell,
And I’m riding for free.
So if you’re down and out of miracles,
I’ve got a pocketful of miracles,
And there’ll be miracles enough
For you and me.”
If any of you have one of those pockets, now would be a great time to use it.
We’re all all right
People keep asking me if I’m OK.
“Man,” they say, shaking their heads, “I don’t know how you can do this. I couldn’t do it.”
Martyrdom is seductive. There’s a part of me that wants to milk the sympathy for all its worth, and often I acknowledge that yes, it does suck to spend your working hours confronting your greatest fear, to write difficult stories about the worst part of life, to grow close to someone whom you know you’re probably going to lose. It’s tough to see people hurting. Every day brings another heartbreak, and sometimes it feels as if I’ve paid twice the ticket price to watch only the last 10 minutes of a movie.
It’s easier to say that than to slap my inquisitors with the truth: “I’m OK. Jim’s the one who’s dying.”
This blog is about me, I guess, but this story isn’t. No matter how sad the tale is, I can walk away from it. Jim, LeAnn, Maddye, Ford and their extended family can’t. I’m a visitor in their lives, a voyeur of sorts. I’m that guy at a party who just sits in a corner and stares. I’m watching them. They’re living.
And the thing of it is, they’re living well. I think sometimes that if I was in Jim’s shoes, I’d be maudlin and downtrodden, cataloging all the ways in which life let me down. Jim is celebrating whatever time he has left, and his family is right there with him. They don’t drown themselves in tears and embrace nihilism; they’re too busy laughing and bickering and deciding what to have for dinner or which movie to watch. Jim doesn’t have time to wallow in self-pity; there’s too much to do: writing a second book, going to poetry readings, doing his job, visiting friends, paying bills and doing one-handed yard work. There’s a fat house cat to pet, a panting dog to let out.
How am I? Better to ask, how are they?
From the look of it, I’d say they’re OK.
Thank you for asking. I am, too.
Our first shared medical experience
I hate hospitals. I know what you’re thinking: “Ooooh, big shocker. Everybody hates hospitals.”
But I really hate them. Just looking at them fills my head with panicked babble, calling up every bad memory associated with them and awakening my dormant hypochondria. It’s fair to say I’m phobic when it comes to hospitals and doctors and sickness of any kind. I can’t watch “E.R.” or any other medical show, not even “Scrubs.” I turn green when my mother-in-law describes medical procedures, and even a whiff of hospital chemicals makes me queasy. All bets are off if I see a scalpel or syringe. I.V.s are scary enough.
So I was a bit apprehensive the first time I went to a medical appointment with Jim. I didn’t say anything about it, of course. I just marched in there with the focused face of a man determined not to wet himself in front of his executioner.
It was Thursday, Nov. 20. We met on the 5th floor of the OU Physicians Building and followed a hallway from the elevators to the cancer center. An open waiting room, maybe 100 feet long, stretched out in front of us — patients to the right, support staff to the left. Pretty women smiled at us from behind high wooden counters.
Jim was there to get the titanium pump in his abdomen drained and refilled with water and a blood thinner. I was there to try to understand this part of his life a little better. With us was photojournalist John Clanton.
We hadn’t been there long before a woman popped out of a door and called Jim’s name. Off we went into a maze of long, narrow corridors that led us to a room packed with medical equipment and a series of leather reclining chairs with matching ottomans. Chemo patients sat in those chairs, some offering furtive smiles, others lying motionless as I.V. arrays dripped toxic chemicals into their veins.
We passed through and entered a tiny, L-shaped private room, dominated by a hospital bed. Jim plopped down on it without hesitation, something I could have never done. To me, it seemed — like all hospital beds — vaguely sinister, an instrument of rest perverted and possessed by a darker spirit. The ghosts of past occupants seemed to linger despite the fresh linens, leaving a residue of fear-sweat and desperate hope.
(Told you I’m phobic about hospitals.)
Diane Boyd and Vickie O’Brien entered the room in a flurry of activity and good cheer. It was Diane’s last work day before Thanksgiving, and she was wearing turkey-printed autumn scrubs. Vickie, wearing a hot pink top over blue scrubs, instantly became the brightest object in the room.
Diane and Vickie have been taking care of Jim for about 14 months. The past four months, that has included tending to his abdominal pump, which was installed to direct the chemo to specific spots on Jim’s liver. The chemo failed to shrink the tumors, and doctors stopped using the pump, but it still needs to be emptied and refilled from time to time.
Jim lay back on the bed, and the nurses pulled up his sweater, exposing his stomach. Vickie tucked an absorbent cloth into the waistband of his chinos. The pump creates a bulge in Jim’s flesh that is noticeable even when he is clothed; with his stomach exposed, the lump seemed more unnatural.
Diane swabbed his stomach with Betadine and alcohol. The Betadine alone was reddish-brown. The alcohol turned it a shade of yellow.
Somewhere beneath Jim’s skin is a port, a hole in the pump that must be punctured with a long needle so the fluid can be removed. The needle is about as long as one used to inflate a basketball, and it was connected to a length of tubing that led back to a pair of syringes. Diane missed the port with her first couple stabs into Jim’s abdomen, and Jim’s face was tense, drawn into a tight frown. On the third or fourth try, the needle slipped into the port, and Jim relaxed. Instantly, the syringes began to fill with clear fluid.
“See, it’s under pressure,” Jim said. “There was chemo in it, but now it’s just water and Heparin.”
Diane handled the delicate part of the process: inserting the needle, operating the clamp. Vickie provided the brute strength needed to force fluid back into the pump, a process that has apparently grown more difficult with time.
“Leverage!” Vickie complained, her hand straining. “There’s nothing there to hold onto. Here, lay it down a bit. Maybe that’ll be easier than holding it straight up.”
“There’s a guy at M.D. Anderson named James who takes care of it,” Jim said.
“Gosh,” Diane said to Vickie. “I think you’re stronger than me.”
“He’s a big old boy,” Jim said.
“Does he have as much trouble as us?” Diane asked. “I don’t remember it ever being this hard.”
“It was hard, but not this hard,” Vickie said. “Let’s rest. One minute.”
“That should be it,” Jim said. His voice was mild.
“We’ve got to get all of that out,” Diane said.
Jim looked at me. “This is somewhat stressful,” he said. “For all of us, I think.”
No kidding. My stomach was in a condition that could best be described as a rolling boil. I couldn’t see myself, but I’m sure I was vampire pale. I was concentrating on two things: not puking and staying conscious. I didn’t say anything. I was afraid what might come out.
Dunno what to say
I’m facing a quandary. I have stories to tell about Jim, but I’m not sure if I want to spend them in this blog or save them for full-on newspaper articles.
I’ve started writing several anecdotes in this space, but have gone back and deleted them all. Can’t tell that one. It might work for my third story. What about … no, no. Not that one, either. It’ll be perfect for the fifth story.
So I’m sitting here wondering what I can tell you. Oh, here’s one:
I was riding with Jim and Ford in their sport utility vehicle south of Austin, Texas. We’d just pulled out of a fast food joint — Burger King or Taco Bell, can’t remember which — and all of a sudden Jim …
Never mind. I want to save that one, too.
Cancer to be No. 1 killer
Found this story from Reuters. Scary, scary stuff.
———–
By Will Dunham
WASHINGTON (Reuters) – Cancer is on pace to supplant heart disease as the No. 1 cause of death worldwide in 2010, with a growing burden in poor countries thanks to more cigarette smoking and other factors, global health experts said on Tuesday.
Globally, an estimated 12.4 million people will be diagnosed with some form of cancer this year and 7.6 million people will die, the U.N. World Health Organization’s International Agency for Research on Cancer said in a report.
“The global cancer burden doubled in the last 30 years of the 20th century, and it is estimated that this will double again between 2000 and 2020 and nearly triple by 2030,” according to the report.
By 2030, 26.4 million people a year may be diagnosed with cancer, with 17 million people dying from it, the report forecast.
In men, lung cancer was the most common form in terms of new cases and deaths, while breast cancer was the most common type among women in new cases and deaths, according to the report. More men than women get cancer and die from it.
“This is going to present amazing problems at every level in every society worldwide,” the IARC’s Peter Boyle said at a news conference.
In the near term, cancer is expected to bypass heart disease as the leading killer globally in 2010, American Cancer Society Chief Executive Officer John Seffrin said. Cancer currently accounts for about one in eight deaths worldwide.
Trends that will contribute to rising cancer cases and deaths include the aging of populations in many countries — cancer is more common in the elderly — and increasing rates of cigarette smoking in poor countries.
Some rich countries have made progress in cutting cigarette smoking, which causes most cases of lung cancer as well as many other illnesses. In the United States, the most recent figures show that for the first time since records have been kept less than 20 percent of adults were smokers in 2007.
However, cigarette companies are finding new customers in developing countries. Seffrin noted that 40 percent of the world’s smokers live in just two nations — China and India.
Decades ago, cancer was considered largely a problem of Westernized, rich, industrialized countries. But much of the global burden now rests in poor and medium-income countries.
Many of these countries have limited health budgets and high rates of communicable diseases, while cancer treatment facilities are out of reach for many people and life-saving treatments are seldom available, Boyle said.
“There are more deaths in the world from cancer than from AIDS, tuberculosis and malaria combined,” Boyle said.
At the same time, progress against cancer has been reported by authorities in such places as the United States and Europe.
For example, health authorities in the United States reported last month that cancer diagnosis rates are now dropping for the first time in both men and women and previous declines in cancer death rates are accelerating.
They attributed the progress to factors such as regular screening for breast and colorectal cancer, declining smoking rates and improved treatments.
Cancer-prevention opportunities exist in countries of any income level, Boyle said, noting that many types of cancer are caused by individual behaviors such as smoking.
Some other “modifiable risk factors” for cancer that Boyle cited included alcohol consumption, too much exposure to sunlight, lack of physical activity and obesity.
Correction:
Jim’s party is tonight (Dec. 10) from 6 to 8 p.m. at the Full Circle book store at 50 Penn. In my last post, I said it started at 7 p.m.
Happy birthday, Jim
Hope you’ll join me in wishing Jim a happy 45th birthday.
Today is his actual b-day, but tomorrow, his poetry publisher and the Full Circle book store are hosting a birthday/holiday party for Jim. He’s going to read some poetry, and his son, Ford, will perform. Party kicks off at 7 p.m. at the book store at 50 Penn Place.
I hope you’ve been reading the other blogs on this site, the ones by Jim and by Charlotte Lankard. My posts are nothing next to theirs. Jim’s telling stories and sharing insights, and Charlotte’s providing some beneficial information for anyone dealing with end-of-life issues. Great stuff.
Meeting the fam
Haven’t spent as much time with Jim’s family as I’d like to, but I’ve got some early impressions. (Jim will have to correct me here if I’m way off base.)
LeAnn – Jim’s wife, a middle school math teacher, is one of those people whose voice always seems to contain a hint of laughter. It lilts along with her words, making her seem lively and happy. Maybe that’s just the way she is when meeting new people, but I get the feeling she’s enthusiastic a lot of the time. LeAnn is a jogger. Or maybe a runner. I know she has run at least one half-marathon and walked another. Jim says she’s a popular teacher. I’m sure he’s right.
Maddye — Jim and LeAnn’s 17-year-old daughter, Maddye, is a high school senior. I’ve spent less time with Maddye than any of the others, so my impressions of her are really vague. She seems sweet and outgoing. Like her parents and brother, she’s friendly and good looking. I know she’s athletic, because she was a competitive swimmer up until the last year or so, and I know she was involved in some sort of teen drama that led to her family’s house getting T.P.’ed and egged about a month ago. Last I knew, she was trying to decide where to go to college. UCO and OSU were possibilities.
Ford — At 14, Ford is tall, thin and musically gifted. He’s not a fan of homework, but he loves to play his guitar and recently bought a synthesizer. When he was 8, he and some friends started a band called Refuje and put out some CDs. That band split up, and Ford released a solo CD. He writes his own music and most of his own lyrics, although his father helps out from time to time with wording. For a performer, Ford is surprisingly quiet and doesn’t demand the spotlight.
There’s a lot of love in the Chastains’ house. I feel kind of sappy writing that, but it’s true.
Working on chapter one
I’m working on a draft of my first Jim Chastain story.
It’s tough going, in part because I’m treading down a path Jim has already made famous in a book about his cancer journey, called “I Survived Cancer, but Never Won the Tour de France.”
Jim’s a talented writer, and he knows his life story far better than I ever will. His book is well-crafted, funny and heartbreaking, and I know I can’t match his effort in a far shorter newspaper article.
I’m giving it my best shot, though. Jim’s story is important to me, at least as and probably more important than any other story I’ve covered. It’s not just about one man or one family. It’s about all of us, everyone who is or knows someone touched by cancer, and it’s about how death doesn’t define us — how we live does.
One of Jim’s friends told me recently that Jim is a wonderful and terrible reminder that we shouldn’t waste what time we have left. Jim will be uncomfortable reading that, I’m sure, but his friend is right — not because Jim’s life may be ending, but because he’s made so much of the time he’s had.
