March 28

I have recently had a series of medical checkups with a very very bad prognosis. No sense wasting time beating around the bush, I have been diagnosed with pancreatic cancer that has metastasized to my liver. It is essentially a death sentence to be carried out at the whim of nature at some later date. I will of course go through chemotherapy and all the other awful procedures meant to prolong my life but there is about a 1, maybe 2, percent chance that any of it will actually stop the cancer. My best outcome is to only delay the inevitable.

So much has happened in the last two weeks that my head is sort of swimming as to the details but not the ultimate conclusion. By the time the cancer was discovered it had spread to my liver and maybe other places, just where is to be discovered later. The worst news is that it had already metastasized. Had that not happened I would have stood a better chance. As it is I am looking at the standard chemo and then maybe a more aggressive round later. I had a stent put in my bile duct to keep it open as the enlarged pancreas had just about choked it off. If I had developed jaundice I would not even be eligible for chemo. I have already started on pain relieving meds, right now it is hydrocodone and some sort of nausea medicine that has a polysyllabic name that would choke an Eastern European accustomed to long names with no vowels. Later it will be stuff that needs signatures just to pick up the prescriptions, more to drop it off and yet more to pick it up. I have met interesting people with very long medical titles like 'gastroenterologist', and the very scary sounding 'oncologist'. It is of some minor consolation that I am in a locality with the finest medical help available, I say minor because there is little that can be done for me. Luckily the new cancer treatment center for UT Southwestern Medical School is only about three miles from the house and it is staffed with the finest cancer people around. I will go there for the chemo. Because of my prognosis there may be options for some clinical trials or more aggressive therapy.

Janice is of course devastated. Poor girl had hoped to have me around for 30 more years. Her world is pretty much caving in. All the way around there are so many situations that this condition brings about. Having to discuss funerals and dispositions of affairs and so on just seems so bizarre, yet is is also necessary. Last night we discussed Janice's work schedule, how much she should work form home and how often she should go in to the office. I made it clear that it is in our mutual interest for her to get away from me so she can see 'daylight' and feel the support of her friends and coworkers so that she does not get sucked into the whirlwind of dark depression that only being around me would inflict on her. So many new concepts and outlooks to consider these days. Never in my wildest dreams did I think things like this would be necessary.

Myself I am facing death with something almost approaching detachment. I am not bitter, I have no denial. I am calm and resolved. I will accept all the indignities that come with chemo and nausea and all the other stuff. I will go through the procedures with as much courage as I can muster. There is no choice after all, just put my head down and get through it all. I have no false hope, I know what the prospects are.

I think about my life and what it was. One thing that has become abundantly clear was that I never really fit into this life. I was always out of step with the people around me, I never accepted the norm and I was not really a mindless drone in the world. For all the good that did. On a cosmic scale, I don't really want to return, if there is any choice in that. I look forward to the clarity that passing on can bring. I have considered so many possible outcomes, I have thought about all the possibilities that I have read about. I would like to have a lot of questions answered when I pass. If that is possible, and if it is still important to me when I am on the other side. In the coming months I will delve into all these questions to the maximum possible with our limited view of things.