Thursday, July 28, 2016

A personal topic

The Last Walk 1

            Life overtakes philosophy.  For two years I have been reading and thinking about the virtue of hope.  I’ve posted dozens of hope essays on my blog and read two papers at professional philosophy conferences.  Eventually, I will write a book on this virtue.  But moral philosophy is practical (a theme in all my books in on the virtues, beginning with Learning to Love).  It turns out that I am exploring hope in a very personal way.
Background: In 2013 my wife Karen was diagnosed with endometrial cancer, involving three types of cancer cells: endometrial, serous and clear cell.  The first is most common, the second and third more dangerous.  She underwent surgery in September, followed by many weeks of chemotherapy and radiation.  The treatment regimen lasted until April 2014.  Chemotherapy stole her hair, but in Karen’s experience radiation therapy was much harder, leaving her with intestinal problems for months afterward.  Still, by summer 2014 she was back at work as a psychological disability examiner.  And she was 62.  She decided to retire.
            That fall Karen began a new career as a freelance photographer.  She took art photos and portrait photos.  She took photography courses, bought lots of good equipment, and redecorated our living room into a studio.  She displayed photos in local coffee shops.
            Throughout 2015 “gut” problems persisted.  In the decade before her surgery, Karen had enjoyed walking for exercise, going for long (45 minute) vigorous walks in various neighborhoods.  But “bowel insecurity” put an end to that.  Late in 2015 she experimented with indoor walks at the local Fred Meyer.
            After the cancer treatments of 13-14, Karen had regular follow-up visits with her oncologist.  At the beginning of 2016, her blood work showed no signs of the cancer.  Karen’s doctor said it was as if she had reached mile 21 of a 26-mile marathon.  She might really be cancer free.
            In February 2016 Karen began experiencing back pain; later, leg pain as well.  Her Fred Meyer walks became too painful to continue.  There also seemed to be something wrong with her sinuses; the aroma of most foods became nauseating, which meant that she began eating less.  These symptoms all worsened gradually.  Doctors prescribed pain medications and ordered CT scans.
            Here we are now, summer 2016.
An urgent message from Karen’s GP: come and see me right away.  The next day, we learned cancer had returned.  Four days later we met with the oncologist and Karen was immediately started on chemotherapy.  There will be no surgery to remove cancer, since it has spread to too many lymph nodes.  The next day, a urologist scheduled Karen for a minor procedure to insert a stent at a place where swollen lymph nodes impeded her ureter.
The oncologist gave straightforward answers to our questions.  There is a very small probability that chemotherapy alone can kill the cancer.  Much more likely, chemotherapy will let us “manage” or “control” the cancer.  “Control” in this context means knocking it back, killing many of the rogue cells.  But we should expect, he said, that each round of chemo (using different drugs at different stages) would “train” the cancer to evade the drugs’ power.  Short of a miracle, the cancer will take Karen’s life, most likely in 2-5 years.
So here we are, two middle-aged people, beginning our last “walk” together.  We hope that aggressive pain management might permit literal walks again.  We look back on my year long sabbatical in 2007-08 as a highlight of our marriage; we took many walks that year.
With Karen’s permission, I have decided not to keep our story secret.  I do not intend to make a spectacle of it.  I will occasionally post updates on our experience.

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