It Doesn't Seem Real...

Denial is a wonderful tool. We learn that early in life. In high school, when you call up that girl to invite her to the dance and she says, "Don't ever call me again," and slams down the phone? Well, all guys know that means she really cares. Later in life, when your boss says, "You're a great worker... we hate to let you go. You're fired," most of us only hear the first part.

I'm guessing that everyone who has cancer has gone through some serious denial. I know I have. I don't look sick. I don't feel sick, except when I'm on chemo. I still walk five miles a couple of times a week. A friend recently said, "If I didn't know you were sick, I wouldn't know you were sick." So how can I have cancer?

I've seen the scans. I saw the white circle on the brain scan that was my tumor. The doctors said it was golf ball-sized, but I think they say that about every tumor. And I knew that one was there, because it made me slur my words. But the tumors in my lungs? I had no clue. Still don't.

You go at this in a couple of different ways. The first is outright denial. How can I have cancer? That's what happens to our grandparents or our parents. But it doesn't happen to us. To me. Well, unfortunately, when it comes to some types of cancer, the fact that it happens to our grandparents and our parents is one of the reasons it happens to us. Genetics. My grandmother had colon cancer. My mother had it. Now I have it.

When I wake up in the morning, sometimes, just for a minute or two, I forget. Then it comes back to me and pretty much never leaves me again. But I have no symptoms. Could it have been a mistake? A smudge on the scan somehow? They switched my scans with someone else? There has to be some other explanation.

Because when I look down at my chest, I know that somewhere in there are evil, malignant tumors that are trying to kill me. My own body is betraying me. But it doesn't seem real somehow. I'm not asking for symptoms, believe me. But sometimes it just seems like my cancer is intellectual, an idea, not something you can see or touch. But then I stop kidding myself. I know it's in there. I know that, most likely, it will kill me.

But that doesn't stop me from dreaming. I still think about things I'd like to be doing in ten years, five years, next year. I haven't bought any new clothes since I was diagnosed this time. I wasn't sure if I would ever need them or get the chance to wear them. But you can't quit. Life goes on.

Still, when a colleague of mine recently asked me, "Do you really have cancer? 'Cause you don't look like it." I was tempted to say, "No, it's all a terrible mistake. " But that's not true. I can't see it, or feel it, but I know it's in there. So I answered her the only way I could: "Yes, I really do have cancer."

6:41 AM ET | 06-30-2006 | permalink

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'Encouraged and Strengthened' by Your Responses

I'm sitting at my computer with tears in my eyes. I have just read all of the e-mails that you all sent in. They are stunning in their eloquence, their courage, their determination. So many of them were from people who have just been diagnosed recently — "newbies," as one writer called himself. Others have been fighting this battle for years, after having been told that their time was short. And there are so many people who have been affected.

Some stand out. The woman who said she would gladly die "a thousand deaths" if that would cure her child's cancer. There are those who spoke of their newfound determination to appreciate every moment of life they have. And there were so many who were honest enough to admit that they were scared. That's not easy to do.

Some wrote of the fear they feel with every checkup. Will the cancer be back? Will it have grown? Good news is a rare gem for cancer patients. There's not a lot of it. The bad news however, comes hot and heavy. And preparing yourself for the worst really doesn't work. I know, I've tried it. As much as you tell yourself to expect the worst, that little voice in your mind keeps hoping for something good, something to hang on to, only to be disappointed so often.

But after reading them all, tears aside, I have to admit that I don't feel sad or hopeless. On the contrary, I am encouraged and strengthened. Having a terminal disease does change you. It changes everything, but not always for the worst. Everyone who wrote in — and the countless others who are fighting this war alone or silently — everyone of them shows strength that they probably didn't know they had before that awful day they got the diagnosis.

I have to admit that this morning wasn't great. I was feeling nauseous, tired — the usual. And yes, I was feeling a little sorry for myself. But reading the words written by those who are going through the same things that I am changed that. It wasn't just their words of concern or encouragement. I guess it was being reminded once again that I am not alone in this. Quite the contrary, I consider myself incredibly fortunate to find myself in such good company.

6:46 AM ET | 06-29-2006 | permalink

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'Blundering Through This Together...'

The party's over. I'm back on chemo, after about a three-week break. Before, I was taking two drugs: one that I got from about a three-hour injection and then pills twice a day for two weeks. That first drug was the worst, so hopefully just taking the one drug will be easier, although I'm already feeling the side effects — fatigue and nausea that never really go away.

Before, I had been resistant to the idea of taking a break, even though my doctors were advising me to. I was worried that even taking a couple of weeks off might allow the cancer to start growing again. Then I would have gone through five months of chemo — and the side effects — for nothing. It struck me a little bit like the little Dutch boy taking his finger out of the dike and saying, "It's just for a little while. I'll see what happens."

The problem is, no one knows what's going to happen when you take a break. Will the cancer grow? Will it stay the same? No one has those answers. So how do you make an informed decision? The answer is: you don't. Even the doctors can't tell you what will happen. It really comes down to the question of how you feel.

And being off the chemo, even for a short time, felt great. For the first time in almost six months, I felt like myself. Taking chemo is like having the flu, except it never goes away. It's not much fun.

But there is a larger issue here. How the heck do you make these decisions? I'm a big fan of Grey's Anatomy on TV. When they're not trying to decide who to sleep with, the doctors on that show always seem to know what to do, at least medically. Well that's not the way it works in reality. Cancer, and the fight against it, is full of unknowns. Will this chemo work? Should I try a different set of drugs? Surgery? Radiation? Nothing?

I have said before that I have some of the best doctors in the world on my team. I have absolute faith in them. But they don't have the answers. They can't tell me what will happen. I was shocked the first time they told me I had to make a decision about what course of treatment to follow. I was expecting them to tell me. I guess we're all sort of blundering through this together.

The bottom line is it really comes down to how much you can take. The current plan is for me to take this drug as long as I can stand it. When the side effects just become too much to take any longer, I'll stop. And then we wait and watch. When — not if — the cancer begins to spread, then we will try a different set of drugs, and see if they're more effective. If they don't work, there are other drugs to try, and finally, out of desperation, I could try to get into a clinical trial of an unproven drug.

I have always been used to being the master of my own destiny. I like to know what's going on, and I like to be able to control what's happening to me. Well, that was my old life. These days, I look down at my chest, and just wonder what the heck is going on inside there. It's not a comfortable feeling.

7:10 AM ET | 06-28-2006 | permalink

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Unanswered Questions

Why me? That's the obvious question. That's the question that, sooner or later, everyone who gets cancer asks. But there's no answer. Oh, I know some of the medical reasons: a family history, genetic predisposition and all that. But that's not really what that question is asking.

Five years ago, I had a routine colonoscopy, and, to everyone's surprise, they found cancer. I had surgery, took a couple of weeks off from work, and then came back. Everything was clean. My lymph nodes, the body system that cancer cells use to travel around, were clean. Now they say that after five years, if the cancer doesn't come back, you're "cured." Well, I was clean for more than four years, and then it came back. Why me?

Anger is the reaction most people expect. But who, or what, can I be angry at? I guess I could go outside and shake my fist at the universe, but really, aside from scaring the neighbors, what is that going to accomplish?

Much to my surprise, I'm pretty much at peace with this, at least most of the time. I've had a full life. I've done and seen things that very few people get to do. I've lived the adventure. So now I'm not looking to go climb Mt. Everest or go bungee jumping or anything like that. I don't have anything else to prove. But I'm definitely not ready to die. There's nothing specific that I want to do — I just have more living to do. I'm not ready.

I want to read the last Harry Potter book and find out what all of that is about. I want to watch 24, and find out how Jack Bauer saves the world yet again. And I want to find out who Meredith Grey finally chooses on Grey's Anatomy. And I want to spend time with my friends, have good conversations, drink a good bottle of wine, enjoy a good meal.

So I'm not so much angry as sad. Sad because, if the doctors are right, my life has become narrower. Until the cancer was diagnosed last December, the world was still wide open to me. There were unlimited possibilities. Okay, I just turned 51, so maybe the possibilities weren't exactly unlimited, but you know what I mean. Now I have to come to grips with the fact that that's no longer the case.

Is this unfair? I can't really say that either, without wishing the disease on someone else, and I'm not willing to do that. And I look around and see people who are having a much harder time than me. I'll never forget sitting in the chemo waiting room when a young man came in with three small boys. Then his wife came in. She was pregnant. And she was the one who was there for chemo. I can't imagine what they are going through.

So, angry? No. It wouldn't do much good, and quite honestly, I just don't have the time for that. I still have things to do.

See you tomorrow.

7:07 AM ET | 06-27-2006 | permalink

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I Wasn't Supposed to Be the Story...

I was supposed to have died last month. That's what the doctors told me six months ago when I was diagnosed with cancer for the second time. Now that was mostly my fault. I kept badgering the doctor for a prognosis. After all, when you get news like that, there's really only one question that everyone wants to ask. "How long?" Of course, no one really wants the answer.

So I've beaten their first prognosis, and now I'm working on the second one. I've learned a lot in these last six months. One of the real surprises is that the doctors really don't know what's going to happen. I am being treated at Johns Hopkins, one of the best hospitals in the world. I have some of the best doctors in the world. But even they don't know the answers to some of the most basic questions. Will chemo work? Would a different drug be more effective? What will happen next? What should I do? And of course, that original question just keeps coming back. How long? They really can't answer that one either. They have studies, and averages, and that's what they tell you. "A person with your disease, on average, will live this long..." But that has nothing to do with your individual case.

So you pretty much have to just blunder through all this. It's not easy. But cancer affects everyone. I don't know a single person who doesn't have a loved one, a family member, colleague, friend of a friend, who has cancer.

But for those of us directly affected, cancer opens up a whole new world. I like to call it a parallel universe. It looks like the regular world, but it's very, very different. It's populated by other patients with whom you share war stories. "What drugs are you on?" "How are your side effects?"

And there are the doctors and nurses who fight like hell to save patients when they know that they will lose virtually all of them.

And there are the loved ones, and no matter how hard you try, there's really no way to comfort them.

This is a new thing for me. I've been a journalist for more than 25 years. In covering more than a dozen wars, I've seen my share of death, but I never thought I'd be talking about my own. I wasn't supposed to be the story. But all that's changed. Now, a number of you have already heard part of my story on Morning Edition. But starting today, on this blog, and in a weekly podcast, we're going to be able to go much further.

I'm going to be talking about my experiences, and I hope that many of you will write in with your own stories, suggestions, complaints, or just send a note when you're feeling overwhelmed by all of this and just need to vent a little. I'm sure you'll all get tired of hearing just about me, so my goal is to turn this into a real dialogue. I hope you'll be back here tomorrow.

6:54 AM ET | 06-26-2006 | permalink

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Commentary: Breaking the News

The following is a commentary from Morning Edition, June 26, 2006:

"How are you?" That's one of those throwaway lines, just part of the ritual. You don't really need to answer. But I was at a party recently, and when a woman I know reasonably well asked how I was, I froze. Because the honest answer would have been, "Not too well. Cancer, a lot of it. Chemo makes me sick most days. Prognosis: not so good." Not exactly party chitchat.

By now, most of my friends know about my cancer, but not all. In that moment, I didn't know if this woman knew. So what to say?

I hesitated for only a second or two, although it seemed like much longer. Then I said something vague like, "Pretty good, how are you?" To this day, I have no idea if she knew I was sick, and was really asking how I was, or if she was just being polite.

When I was first diagnosed, I called some very close friends and e-mailed others. I hated doing that — it just seemed too impersonal. But to be honest, I was having trouble getting through those early conversations. It was bad news. Bad for them to hear, bad for me to say. You can't really back into something like that. So I just sort of bulled my way through, "Listen, I have some bad news." A number of friends broke down in tears, and I found myself comforting them, which seemed an odd role reversal.

Some people even have trouble saying the word "cancer." When I had it the first time about five years ago, I was getting a CAT scan, and the technician said cheerfully, "well, we're looking for 'C.A.' today." I had no idea what she was talking about. Turned out she couldn't, or wouldn't, say the word. Cancer. But it's just a disease. We have to be able to talk about it.

That first time I was still working at Nightline, and had to hold a staff meeting to tell everyone at once. That was tough. There were tears as I looked around the room at my friends and colleagues. I tried not to make eye contact, because it seemed important to me to not break down. I needed to let them know that it would all be OK.

These days I pretty much have it down to a science. I have different versions of my story. A really honest, detailed one for close friends, whom I want to know the truth, all of it. For people I barely know, but who are kind enough to ask, I have a version that's pretty vague. I'm not sure they want to know everything. I don't want to share it all with everyone either. And then I have a couple of versions in between.

It's still difficult to tell people for the first time. I believe honesty's important. But... there's honesty, and then there's honesty. I tell people as much as I think they want, or that they can handle. And I worry about becoming boring, that cancer is the only thing I talk about. I still want to talk about Iraq, politics, the latest plot twists on 24 and the craziness of American Idol.

The other day a friend said, "If I didn't know you were sick, I wouldn't know you were sick." And that's fine with me. I have things to do, a life to live. Cancer is not an excuse for quitting. So sometimes when people ask, "How are you?" the answer is just, "I'm OK."

6:37 AM ET | 06-26-2006 | permalink

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