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ELEVEN RULES FOR PANCREATIC CANCER PATIENTS
I have found that I do most of my best thinking on a tractor. The hum of a sweet running diesel is a white noise that shuts out all sounds and lets your mind wander and digest important things. Did you know that Einstein stumbled across his theory of relativity while riding on an old Chalmers two-banger, the Wright brothers were plowing the field at Kitty Hawk and John F. Kennedy dug into Vietnam after he borrowed a Massey-Ferguson to trim around Hyannis Port. - - - That is to say, a tractor does not guarantee the right answer but only that it is well studied. Maybe Massey-Fergusons are just not as good at thought provoking. Obviously, George Bush has never driven a tractor.
Yesterday and today I started the spring hay baling. Having cut 70 acres or so, I have until tomorrow night to get it off the field before it rains. With the company of three fine dogs looking for rabbits and a host of barn swallows circling the tractor to catch and carry the scattered insects to their nestlings, it has been a renewing experience, as it is every year. I decided to succumb to Judy’s years of wooing me in a decision made on this same tractor, one of my life’s best decisions.
I am convinced that when Moses came down from the mountain on his first trip, he carried a single stone tablet with only one commandment that read: “Conceal Nothing,” kind of like the eighth commandment, but if honored, the other nine could never be broken. Think about it. But then Moses got so mad, he chucked the tablet at the golden cow and went back up the mountain shaking his head and said, “The human race is too stupid for just one rule, let’s work out a more detailed list.” Moses really needed some tractor time.
In the seven months since my pancreatic cancer surgery in September 2006, it has been too cold and rainy to get in much tractor time. The result this time is a rather sobering list, yet unfinished, of things I learned and wanted to put down on paper before the office pressures, other pressing things and other not-so-pressing tasks pushed them from mind. Being that there is no golden calf to chunk them at, I am throwing them to you with the claim only that they are the best that three dogs, a bunch of barn swallows and a big diesel could do this day.
Eleven Rules for the Pancreatic Cancer Patient
Rule No. 1: Remember to treat your spouse with exceeding love and courtesy. If she/he gets mad at you, you are going to starve, you cannot get your medicine or even get to and from the bathroom or doctor. You will shrivel up somewhere in some back corner of the house. Really, this PC stuff is so much harder on your partner than you anyway. They have the ever-so-painful wherewithal to worry, care and cry when you are too sick to do that for yourself. Also remember, if your wife/husband gets hit by a truck, you might as well go and stick your head in the toilet and drown. Without them, you are not going to make it anyway.
Rule No. 2: Do not ask any question to which you know that you will get the wrong answer. For example, never ask your doctor if you can have scotch or alcohol. You know what he’s going to say, and believe me, you do not want to hear it. Similarly, do not ask him about smoking. Every doctor is going to tell you to stop smoking, PC or not. Conversely, do not ask him if you should exercise. Of course, he’s going to insist upon your exercise. Do not ask him if you should eat your vegetables. Of course, he’s going to tell you to eat all of your vegetables, PC or not. Thus, if you don’t want to hear the answer, don’t ask the question. Think ahead before asking anything.
Rule No. 3: Secretly call your doctors and ask them to assert the patient-physician privilege so that your spouse cannot be in the room with you when you talk to your doctor. She/he will only ask questions to which you do not want the answers and you will end up getting more shots and ten more different medicines. You will end up getting more chemo drugs added to the plastic bag and these will make you feel even worse. It’s better to put the doctor in a position where he has to think up all these bad things by himself and there’s a good chance he will leave some of them out and you will get by with fewer shots, less medicine and you might be able to drink scotch and smoke.
Rule No. 4: As one of the very first things, always check out the religion of your surgeon, your oncologist, your endocrinologist and radiologist. If there is an Evangelical Christian in the bunch, you will not be able to drink alcohol. If there is a devout Baptist or Church of Christ in the group, people from all over the town that you do not even know will start praying for you, and if your surgeon is unsuccessful, it will have become “God’s will.” If there is a Catholic (as I am) in the bunch, there will be nuns with rosaries and someone will come by to talk about a bequest in your will to the church. Good doctors who don’t go to church will trust their own ability without hedging their bets with the need of God’s help. I think I like that better. Rule No. 5: You need to get an absolute guarantee of how long you’re going to live – not maybe’s, not “as long as,” “if this” or “if that” ... With that exact date in hand, you can closely time the spending of your kids’ inheritance. You can get the boat you always wanted, sail, travel, fish – make the very best use of your time and savings. You can retire with exactly the right amount of money in the bank to last through your funeral. One way to look at it is that PC in this way is a blessing, better than letting some nut run over you with a truck, shoot you for your watch or get hit by a falling tree and never get to use your savings.
Rule No. 6: Make a long list of all the work that needs to be done around the house while you are still skinny and weak. Then when everybody you know comes by and says: “You know you can count on me, if there is anything you need doing, just call.” Right then and there, pick a big chore and assign it to them. Schedule the exact day and time of day for them to do it - - paint the house, re-roof the garage, rebuild the truck transmission, etc., etc. Then when the chore date arrives, struggle shakily to your room with a good book and let your spouse supervise while telling them how bad a day you’ve had. Very soon everything that needs doing will have been done by the time you are ready to do them and you can spend your time on more pleasant things.
Rule No. 7: Take vengeance on every vegetable you hate to eat. Develop a believable choking/throw-up reflex heave. Then when black-eyed peas are put before you, heave a couple times and say, “Honey, my surgery just will never let me eat those things again” or “I am sure I will lose it all if I just smell of your sister’s lasagna” or “Asparagus really makes my scar hurt.” Get back at the nasty vegetables that have unmercifully besieged you all your life.
Rule No. 8: Since you will lose so much weight that no clothes you have will fit you again for years, discover Ebay and open a Paypal account. Then type in the search box exactly what you need, say: Burberry suit 42, Banks pants 35, Bauer coat L, etc. You will get 50+ hits on each search, some “new with tags,” some “excellent condition.” Today I have a $15,000 wardrobe and spent about $600. My best deal was a new Burberry suit ($1,200) for $11.50, a Gortex Bauer winter coat ($300) for $21, six Joseph A Banks and Robert Stock suits/jackets for almost nothing.
Rule No. 9: You will go crazy laying in bed if you don’t get something constructive accomplished every day. Make a “to-do” list of every big and little thing that you have been meaning to do: get the car detailed, tires aligned/rotated, mower serviced, statue repaired, find the generator you wanted, order tool hangers for the garage, check out prices on landscaping pavers, check out and lay out an order for copper gutters, order flowers and trees, order hummingbird feeder for window, call about materials and contractors for painting, repairs, planting, cleaning. From the kitchen table on your phone or in front of your computer, you can accomplish hours of constructive achievements. While you may not be able to complete some of the tasks, you can have the materials ready or maybe you can catch one of your friends in his “anything-I-can-do” mood and get something accomplished.
Rule No. 10: And, if you’re really, really lucky, you can find yourself a “Mauricio.” I found Mauricio at the parking lot where all the Hispanics gather looking for work. He speaks reasonable English, has his own transportation and has proven to be the most honest and most helpful man I have ever known - - - and he can do anything and Judy really appreciates him. Thus far, with only a little demonstration, he has transplanted 300 cedar trees to a windbreak, serviced all the tractors and equipment, weedeats, mows, plants, repairs and is thrilled to work around the farm. In fact, I worry that when I am well, Judy will weigh our respective abilities and pick Mauricio over me as her worker.
Rule No. 11: This last rule is going to be a little hard on you, especially your spouse who every minute is urging, sometimes honestly, the positive side of everything. But, somewhere between the diagnosis and the treatment, we PC patients need to know the very worst thing that can happen. Maybe it is just three months to live or a long painful illness with serious debilitating complications. Maybe it is a succession of milestone percentages: a 40% chance of surgery success, a 60% chance of diabetes with 10 self-administered shots a day (with finger sticks too). Maybe it is just a Whipple or a distal with three hellish months of losing weight, not bearable to eat until you’re shrivelly skin hangs down from the bones. Maybe all your hair will fall out. - - - Only then can we begin to see the brighter side: for example, without hair, we can paint our bald heads blue with a silver stripe and not have to wear a motorcycle helmet. With two or three years to live, we can make a long list of exciting and important things to accomplish. Money becomes less relevant and an apology to a friend like we meant to do years ago becomes important. Getting a new mower that Judy likes to drive and finding a Mauricio become paramount. Then if all goes better than expected, I can relax, fish, etc. and let Judy and Mauricio do all the farm/yard work. If this rule needs a name, it is the “Come What May” rule that allows a calm acceptance and the only peace among all the regret and worry.
May 1, 2007
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