Fingernails on my Blackboard

I haven't posted my latest gripes and grievances in a long time. So to make up for this shameful neglect, here's a sampling of what's been making me pull my hair out recently.

1) People's "bad moods" - I hear this a lot lately. "Oh I'm in a bad mood, so watch out." Or "she's in a bad mood, don't take it personally." Well, you know what? Screw your bad mood. I have reasons to be pissy each and every single day of my life, and if I wanted to I could be petty and selfish just like you and expect everyone around me to react to my "bad mood" but I'm not doing it. Why should I, or you, expect everyone else to suffer for something you probably had nothing at all to do with? You're mad at your husband for not helping around the house? Well, tell him about it, don't fly into a rage at work because I misplaced your precious pen (which isn't yours anyway, it's the company's). Upset at the kids for doing poorly in school, or asking for too much money? Ground them and take away their allowance, don't get all huffy with me because I don't fall in lock step with every anal retentive habit you have developed over the years. Focus your anger on the source, suck it up and be kind to those who had nothing to do with your personal issues; if I want drama, I'll rent a Dustin Hoffman movie.

2) Babies or Small Kids Talking like Adults isn't Funny, it's Creepy - From that horrific Etrade commercial with the slobbering infant proudly proclaiming his online trading to those equally chilling American General commercials with toddlers nasally (and almost certainly, uncomprehendingly) spouting off dire predictions about their family's financial futures, we seem to be awash in ultra precocious brats preaching to us clueless adults. I guess Madison Avenue assumes that the baby boomers (and now Gen Xers) are thrilled and comforted by the notion that their kids are not really just blank slates waiting for parental imprinting, but in fact totally self sufficient and prescient mini adults who are capable of lecturing their elders. It's yuppie wish fulfillment at its most negligent and narcissistic.

3) The death of observational comedy - Does every single comedy from now have to feature Jack Black, Steve Carrell, the crew from "Knocked Up" or the Farrelly Brothers? Sure, there's a place for gross out, frat house, "irresponsible young adults having to face reality" comedies, but whatever happened to the more mature, subtle stylings of people like Woody Allen or Albert Brooks? Both of those guys are admittedly getting a bit long in the tooth, but isn't there a budding satirist out there who makes his points with a feather, rather than a hammer, touch? Maybe I'm just getting old myself, but I miss comedy that didn't rely on some form of bodily fluid or outrageous sight gag to make me laugh.

4) Music - Seriously, has anyone really heard anything worth listening to in the last, oh say, fifteen years or so? Frank Zappa once said that the world will end not in fire or ice, but nostalgia, but I'd argue that it's not so much a longing for the past that makes millions of people turn into oldies stations everyday, it's a dearth of quality contemporary tunes. There's some listenable stuff with lyrics that stick in your head for a few days, but do you really think that in 30 years anyone will be listening to "Stronger" on a "00's Classics" station? Or that there will even BE such a thing as an "00's Classics" station?

5) Everything Around Me Is Dangerous, And It's all My Fault For Not Being More Organized/Cautious/Prepared/Diligent - Well at least according to the evening news. Let's see, there's mold in my house that could ruin my property value and potentially kill me, there's millions of disease ridden bacteria in my kitchen, there's lead and asbestos lurking in the walls just waiting to poison me and/or give me cancer, my cars brakes don't work right, the gas I put in it has too much water, all my kids toys are either toxic or going to choke him to death, there's radon floating undetected everywhere, my smoke alarms don't work right, I'm not drinking enough water, my cholesterol's too high, everything I eat has too much sugar or sodium, diet soda has preservatives that affectively switch off my DNA, I'm almost positive I don't have enough insurance, there's scores of online hackers just waiting to steal my identity and ruin my credit and there's insects, well, pretty much everywhere.

All of this information about potential hazards in your life is fine and usually well intended but there's such an overwhelming glut of it in the modern world that if you really took all of it to heart you'd scarcely be able to get out of bed in the morning, let alone lead a productive life. Life involves risk and danger, and with the information overflow we seem to be facing lately, it's almost incumbent upon the individual to either judiciously screen his/her time consuming that information or at the very least, try to come to some kind of reasonable truce with the catastrophic nature of most of it. All of these things are things that could POSSIBLY happen, but there are also things that could have happened ten, twenty, or fifty years ago but no one was unduly stressed by them because we either didn't know about them or we weren't so relentlessly pounded with alerts and warnings about them. Either way, it's important to put some kind of boundaries and filters on our personal daily information intake, lest we end up barricaded in a home with a shotgun and boxes of hydrogen peroxide, bleach, insect repellent, mold killer, anti virus programs, water bottles, and canned foods (low fat and sugar of course). Life's a scary place but ultimately, we won't get out alive anyway and obsessive concentration on the bad stuff that MIGHT happen is going to make the time we have here much less productive, and truly unpleasant.

I've got tons of other gripes, pecadillos, pet peeves and cultural nemesis', but I'm tired so that's it for now.

The Invisible Hourglass

One of the worst days of my life was the day that my mother came home and told me that her doctor had suggested she only had two years to live. From that point forward, it was a constant struggle for both of us not to become obsessed with numbers and "lifeclock" watching. "I've got two Christmases left...and I might be very sick by the second one..." "Two years means maybe one of good health and one where things are getting pretty bad"..."Two years is twenty four months..." It was maddening and ultimately self-defeating. Any chance my mom had of extending those odds and defying the doctor's prognosis was being jeopardized by the stress of feeling the daily "tick tock" of that doomsday clock.

As we went through the process of her disease, we discovered that not only did she have severe emphysema, she also in all probability had lung cancer. (Her emphysema made her so weak that the doctors couldn't safely extract a biopsy sample, but several tests strongly suggested the spots on her lungs were cancerous, and similar tumors were later found in her liver.) We went through what I now realize is a typical emotional roller coaster ride for cancer patients and their families. Despair, hope, more despair, another glimmer of hope, confusion, frustration, depression, more hope, etc. You live from test to test, from appointment to appointment. You fear every phone call after a major test, you become hypervigilant to each and every symptom. And we heard about more prospective timelines. After it became clear that my mom almost certainly had lung cancer, one doctor suggested that she might have "eight months, and maybe a lot less". Her radiologist informed us that "the normal life expectancy of someone with cancer is about one year, though some people live much longer." Later, after a round of radiation and the subsequent discovery of cancer in the liver, the doctor we went to to see about chemotherapy told us that if the chemo worked, she might survive 9 to 12 months, and if she opted not to do it, she might have 3 to 6 months. It was like someone had turned over an invisible hourglass and we had to live our lives knowing that the sand within it was slowly draining into the bottom. But since we couldn't see the hourglass, we had no idea how much sand was left, only that it was running out.

Recently, a good friend of mine named Fred was told that, depending on what treatment option he took for his lymphoma, he might expect to live either 1-2 years or 4-6 months. He chose the latter option, because the former would entail much more intensive treatment that brought with it much more discomfort. Now as I talk to him, I see the same frightened sense of urgency, the same understandable obsession with time and numbers as my mom and I experienced. He's torn between trying to find ways to extend his life, and preparing for the apparently inescapable eventuality that it's going to end fairly soon.

And I notice the same conflict within myself in my conversations with Fred as I had with the situation with my mom. I want to be comforting and encouraging, drawing out whatever fight he has left in him, while at the same time I want to be able to speak to the reality of the situation and not give him false hope. The problem is, I don't know which side to fall down on, and if I try to balance the two, I often feel like I'm hedging my bets and being either less than honest or unnecessarily grim.

I sometimes wonder if I shouldn't have spoken about the finality of things more with my mom. Oh sure, we both heard the outlooks of the doctors. We both knew that emphysema never really gets better, and we knew about what lung cancer does. The question was always "how long?". During the entire period of her illness, there was always someone who said "no one can say for sure." When my aunt and I took her up to Rochester Minnesota to the Mayo Clinic for an evaluation, I told the doctor who saw her about the "two year" comment. He apologized to her on behalf of the other doctor and said that "he didn't have a crystal ball, and neither did the other doctor". This comment really buoyed my mother's spirits, and gave her renewed hope. While the doctor didn't sugarcoat things and said he fundamentally agreed with the original diagnosis, he also acknowledged the essential "unknowableness" of the situation, and took the power of the situation out of the hands of science and placed it at least partially, in the hands of fate.

But the difficult thing for cancer patients and those who love them is, "what do we do with the knowledge (or opinion) once it's spoken?" How do you balance hope with reality, resistance versus acceptance? I remember shortly after we heard my mom's prognosis, I told her that I didn't think we should obsess about the "two year" remark. I told her that instead I'd ask her each day how she felt and we'd just go from there, because ultimately, that's about as much as any of us know. I told her that I didn't know that I wouldn't be hit by a car after leaving the house, or get a disease myself, or any of a hundred other things that would end my life could happen. Obviously, I knew the odds of her passing sooner than I were much greater, but as far as the "truth" goes, that was out of our hands. I just hated to see her totally in the thrall of that invisible hourglass; I wanted her to be herself in whatever time she had left, not someone totally defined by fear and a sense of dread. I don't know if that was the right thing to say or not, and obviously something like that is a lot easier said than done, for the sufferer and for his/her family.

I don't blame doctors for simply answering questions. In both my mom's and my friend Fred's case, they asked the doctors about possible lifespans. The doctors were simply answering based on their experience and the experience of others. And I certainly don't blame my mom or Fred or anyone in that situation for asking. I'd want to know too; at least, I think I would. It's a question you ask on impulse but later I often wonder if my mom didn't regret it a bit. Ultimately, who knows? Situations like that are so intense and so stressful it's difficult if not impossible to know what the "right" response is. If you lean toward hope too strongly, you may end up denying the patient a chance to effectively come to terms with the unchangeable eventuality of their disease; they may be so busy fighting in their final days they don't have a chance reflect, to come to a sense of peace, to say goodbye to loved ones and leave whatever instructions they might choose to. If you lean toward reality too much, you might make the patient feel bereft of hope, totally depressed and unable to see beyond the grim future that lies ahead.

Striking a balance between hope and reality is likewise very difficult; perhaps no one really hits upon the correct mixture in their exchanges with loved ones who are facing terminal illnesses. In the end, perhaps all of us; doctors, patients and loved ones are all in the same murky ethical and emotional boat, simply sailing along in the dark and hoping not to hit anything solid in the process. The ultimate truth is, that like so much of our human experience, no one knows the ultimate truth about how to approach terminal illnesses. We have modern medicine including technologically advanced diagnosis techniques, increasingly effective treatment methods and revolutionary medicine. We have psychological counseling, grief intervention, and religious communities all well equipped and experienced with the process of dying. But in the end, nobody knows for sure. We have to just move forward in the most caring, compassionate way we can and hope that it's right.

My mom only lived for 13 months after her "two year" diagnosis, but she lived for eight months after the "eight months, maybe a lot less" diagnosis. She was preparing for chemotherapy when she got very ill very quickly and passed away. I hope I approached the situation in a way that helped her through it, but again, all I can say for sure is that I did the best I could at the time. While we didn't talk explicitly about death very much, I know it was on both of our minds a lot and it informed and influenced most of our conversations and interactions from that point forward. We had some good times, as always; some quiet times in which we both were silently but noticeably thankful for the other's presence and the loving bond we had shared for so many years.

Fred is still fighting his disease, and I'm in his corner encouraging him. Maybe things will change as time goes on and I'll have to approach it differently, but as with my mom, I'm trying to follow what best suits the person suffering. I suppose it's fitting in a way that the end of our lives should be no more clear cut and no less mysterious than the rest of it. It's an agonizing process, but we are apparently destined to never know for certain how much sand is left in the invisible hourglasses of our loved ones, or in fact, in our own. As long as we alive, we should be alive, not dreading each passing moment or projecting too far into an uncertain future, but cherishing each grain as it falls, respectful that we all only get a finite number.