Thursday, December 13, 2012

Taking on Cancer Again, This Time With the Wisdom of Age - NYTimes.com

After I finished eight months of treatment for testicular cancer in my mid-20s, my psychologist said, "Well, that was like having five years of therapy all at once." What he meant was that you learn a lot about yourself in weekly talk sessions, but during a life-threatening illness, the "issues" come at you nonstop. I relished the slow unfolding of myself in the first, but I resented — no, hated — every step of the second. Nearly two decades later, when confronted with the same diagnosis, I finally understood the benefits of that earlier trial by fire, much as I did the wisdom of Ralph Waldo Emerson when he wrote, "The years teach much which the days never knew."

To be sure, there were benefits to being young — I was 26 — when I was first diagnosed, not the least of which was my competitive swimmer's body. After almost dying in the I.C.U. and becoming a "patient-in-residence," I plunged back into the pool (and my day job) just a fortnight after my release.

Ah, the determination — and denial — of youth.

But facing cancer at that young age had more drawbacks than benefits, not the least of which was losing my sense of invulnerability when confronted with the prospect of disfigurement and disability, even death.

Less obvious, but still unsettling, was the loss of my laissez-faire attitude toward life itself. I had always been the kind of guy who focused on the journey (the experience) more than the destination (winning). During backstroke events prior to falling ill I was more interested in watching the clouds race overhead than the swimmer racing in the next lane. This mindset didn't do much for my success in the pool, but it helped define who I was.

To make matters worse, conventional wisdom says only one thing matters when it comes to cancer: Beating the hell out of it. Suddenly I had to find an emotional depth I hadn't sought before, a passion for a fight that I didn't want.

Am I the kind of person who can win this battle? I asked myself early on.

To ensure that I was, I did a complete about-face, saying "No way" to the journey and "Hell, yes" to the destination. Every decision began to turn on life and longevity, and for that I tolerated side effects like hair loss, neuropathy and "dry ejaculation" — because I simply had to win.

I re-read Dylan Thomas, who told me to "rage, rage against the dying of the light," and I did. I became a rager. And it almost ruined my life.

Not in terms of my health, because in fact my treatment was effective. I was "clinically cured" and chalked up that achievement to my new "Top Gun" mentality. Then I jumped back into daily life — and managed to mess everything up. I applied my new approach to relationships ("My way or the highway"), and got dumped by my boyfriend. In graduate school, I aced my studies but lost friends.

Fortunately, my best friends didn't hold back on telling me I had become a jerk, and that got my attention. I had upshifted at the start of my treatment, but now I needed to downshift. I struggled to find my pace, but eventually found a middle gear, more vulnerable than I cared to be but also more human.

The second time I was diagnosed, the oncologist sat me down to give me the new installment of the old bad news. I surprised myself and my friends with a very different approach.

I did not rage, which isn't to say I was happy about this predicament. And I had moved on from my original question to a new one: How can I go through this and still be the kind of person I want to be?

In the intervening years, I had come to realize that cancer victories are not won by personality types, but by a combination of doggedness (choosing the best physician, getting the right diagnosis and treatment), responsibility (doing your own research and taking care of your overall health), and plain old luck.

From that very first day of my second time around, I challenged myself not to shift into that "win at any cost" mentality. That's where the gift of age and experience came to my aid, even if my older body did not. Over the years I had learned that life was not a series of choices between winners and losers — I knew that way of seeing things to be oversimplified, if not dead wrong. You can be stronger than an ox, never miss a day of work, or swim your lungs out and, damn it, still die.

I could become a jerk again and focus on the end point, or I could accept that the journey is the destination – which I did.

Two months after I had been diagnosed and two days before the surgeon was scheduled to excise my remaining testicle, I had a dream so vivid — "I am cancer-free!" — that I demanded to go on a "surveillance" protocol. Reluctantly my doctor agreed, but by year's end I had "won" the debate when my so-called tumor was reclassified as a benign nodule.

The years had taught me much — both to listen to my body and to trust in its wisdom. And, most importantly, to find the courage to speak its truth — whether in the doctor's office or out in the world.

Steven Petrow writes the Civil Behavior column for Booming, addressing questions about gay and straight etiquette for a boomer-age audience. You can find him on Facebook and Twitter.