Only nine days have passed since we returned to New York after our idyllic month in Europe, but it seems much longer. The relentless humidity poses its constant dilemma of putting up with either the fetid atmosphere or the noise of air conditioners, and it is sobering to reflect that there are many more weeks to endure before we can expect any relief. Every year I promise myself that never again will I suffer a New York summer. Perhaps this time my hope will finally come to pass.
It did not help that I managed to pick up a covid infection on my travels home, which led to some mild cold symptoms but also, more annoyingly, the need to stay indoors most of the time and to mask whenever I was near others. Thankfully that seems to have passed, but it is my third cold-like experience since April so my resistance must be low.
The return to the US also seems to have heralded another new phase in my cancer journey. A scan on Friday was followed by a series of consultations yesterday. There does seem to be new tumour material developing, and now the added complication of a tiny new spot on the opposite side of my brain.
The situation does resemble the months after my initial diagnosis. Lots of tests did not help a lot to clarify the diagnosis, but after a while the oncologists decided to act based on their best available guesses. This time their first action will be a biopsy next Monday of the other side of my brain. The hope is that this will either show up the new spot to be harmless so they can concentrate back on the right side, or something less benign in which case new treatment will have to address the issues on both sides.
Whatever the findings, we are expecting this procedure to signal only the beginning of this new phase. It will probably take a few interventions before a decision is made for a prolonged course of treatment. Part of me is quite relieved that this is happening during the summer, when there is precious little else to do in New York, and with some apparent urgency, so that we can hope that our move to Portugal is not delayed.
Nonetheless, all the news yesterday was a bit confusing and disturbing and will probably take a few more tearful days to digest fully. We have been in this situation before, and that experience has given us some tools to help us cope.
Important among those tools is to find ways to stay positive and to be thankful. As usual, relief comes as soon as we focus our minds into those directions. It is a simple and wonderful balm.
One reason for cheerfulness is our confidence in our clinical team, notably our lead oncologist and his neurosurgeon. They are obviously both established leaders in their fields, and their communication and behaviour is exemplary. Yesterday, bouncing between consultations, I heard evidence of them changing their minds about the best approach at least three times. Some people might be annoyed by that, but I only derived positive emotions and insights from their indecision. They acted as a true team, consulting each other frequently, as well as allowing us into their deliberations, showing respect as well as humility. We are truly lucky to have these two gentlemen at our service.
Then I can always derive comfort from how I am usually feeling. How could I be about to keel over when I generally feel so well and am able to carry out such a regular life? There may be damage in my brain, but it still seems to be able to function quite well. When I look around me in the street on in a subway car, most of the people of my age seem to be much worse off health-wise than I am.
There were a few quotable quotes from my consultations yesterday. Each oncologist visit involves a series of cognitive and physical tests, and I continue to ace all of them, except for the glaring gap in my left-side peripheral vision, which is no great inconvenience. The oncologist delegates all this to his nurse practitioner, but I noticed yesterday that he watched quite carefully. His verdict at the end was quite telling. He described me as neurologically intact, a new term to me. It was clear that he was quite impressed with this, and I could only reflect how lucky I am compared with most of his patients at this stage of their treatment. Later in the day the neurosurgeon appeared to show a similar emotion.
Then I feel truly blessed with the support I have received from friends and family, especially from my wife. We trust our medical team, but it is even more valuable that we trust each other. During difficult weeks like this one, we have established a routine of stoic acceptance followed by quiet reflection and then shared determination to move forward together. It is so obvious to each other that our primary motivation is the welfare of our partner, as we continue our parallel journeys to different destinations.
Our team is also supported by our shared dream of moving back to Europe and being able to spend even a short period of healthy time there together. We can almost touch the moment when that dream can become a reality now. The shared goal binds us together. We occasionally debate tactics, but always from an attitude derived from that shared goal. This is another powerful blessing.
No doubt I will once again be consumed by dread in the hours before the procedure on Monday, and no doubt there will be even tougher challenges ahead, perhaps very soon. But, almost all the time, I do not find it difficult to remain hopeful and thankful. By now we also have a lot of experience to draw on. Whether the current set of challenges feel new or somehow a repeat of what we have already been through, we feel we are as ready as we can be to face them, and to face whatever consequences may follow. I will remind myself of that as I ride the subway on Monday morning to the next episode in this drama. Our mantra has not changed. Reject anger, accept fear and fate, find solace in thankfulness. We hope that this mantra can still guide us, no matter how many times we seem to go around in medical circles or how much uncertainty we face.
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