I’ve been a bit inattentive to my writings of late, a lot going on and truthfully, many things to say, just not sure how to say them.  I began writing this the weekend of Good Friday and have now just finished it, lots of issues, some technical others just life; know that context when reading.

Since my last entry, a number of things occurred, some good, some not so good, some inconsequential.  I think there are times when all things fall in these categories, it’s just how life works.   Personally, in the latter part of March I had my first PSA since September.  It was kind of important in that I looked to it as something of an indicator, a factor in some decisions I’ve been pondering.  I’ve intensified my effort to move to the Washington-Baltimore area where my son will attend college and equally important, its proximity to Johns Hopkins.  I shared some thoughts with someone I knew from high school, someone with whom I “reconnected” through the wonders of the social networking phenomenon, more on that another time.  A friend asked that I become involved in a company he is forming, mostly providing assistance writing the business plan – a nice diversion and perhaps assuming the role of CFO.  More globally, the health care bill passed, in a very partisan way.  Interestingly, I took the time to read much of the bill – perhaps I need a life, as much as to understand its contents as to compare its contents to the rhetoric swirling around it.  All things new discoveries and all carried enlightenment.  For my uncle, it was a bit more disturbing, his bladder cancer is advancing rapidly and it is apparent his treatments to date were unimpressive.

The weekend beginning with Good Friday brought with it a number of “comments” by my Facebook friends about various things religious.  It also seems that many of the television programs I watch, particularly Bones and a rerun of Law and Order, dealt with death in some fashion.  For me, I thought of a Bible verse, specifically, Matthew 10:36.  It is the amalgam of all these influences that I will be writing of in this entry.

I’m not an avid reader of the Bible and therefore far from an expert or, for that matter, all that familiar with its specifics.  For those unfamiliar with Matthew 10:36, it says “And a man’s foes shall be they of his own household”.  While the verse has its own interpretations within the context of the story, I choose to extract the words to stand on their own and suggest my own interpretation.  In order to embark on that path, which ties together at the end, I offer color on the events and exposures experienced in my world the past few weeks.

First, I mentioned I had my first PSA since September.  Those who follow my writings know my previous PSA, 7.3, measured in September of 2009, was falling, the continued effect of the treatments of the past year.  The last measure reflected a turn to once again rising – it was 10.7.  Historically, my PSA tends to double every 3-4 months, I am now curious as to when the turning point came, the point of inflection where the rise began since it will indicate when I do additional treatments.  More importantly, I began to re-consider my longevity and decisions affecting my future.  My first reaction was securing some measure of time from my oncologist, his guesstimate was I have 3 years remaining.

Next, I learned my uncle’s condition is clearly deteriorating and requires some response.  The plan, surgically remove his bladder.  Several months ago (around December), when I first learned he had an aggressive form of cancer, I offered to arrange an appointment with the doctor I know at Hopkins, he declined.  He said things were moving forward where he lives; no need to travel for what, as it seemed, he considered the same level of care.  Fast forward to about the middle of March.  We learned things were somewhat complicated.  Surgery scheduled for January was delayed and he was having difficulty getting it rescheduled.  Following a week of frustration and with encouragement from several siblings, he agreed to visit Hopkins on the condition the visit gave him at least a two week time advantage.  My Hopkins doctor suggested he see their world renowned bladder specialist, someone whom he gave unusually high praises and my uncle declined, the appointment would not come soon enough.  Relatives living near Baltimore encouraged him to go to Hopkins, compelling him with the idea of his doing it, not only for himself, but for those who care about him.  In short, it was a plea to do all possible to extend his life and to consider his quality of life, not only for himself, but for those around him.  For me, it was more a matter of another opinion, a new perspective from a highly regarded practitioner.  As things turned out, he had surgery yesterday, they removed his bladder, lymph nodes and prostate; pathology reports available in 7-10 days will determine prognosis.

For me, the rise in PSA suggests I will be compelled to address the situation sometime near the end of this year.  Historically, when rising, my PSA doubles every 3-4 months which suggests I will be in the 70-90 range by December, pretty high by most standards, but not terribly so given my etiology.  As for my oncologist’s “guesstimate”, significant to note is his stating that I’ve “done remarkably well”.  I think this is confirmed given some of those similarly diagnosed near the same time as I, have died.

With the television programs I mentioned, each depicts character dilemmas provoked by their role in the death of another.  In the Law and Order episode, it was the prosecutors and police struggling with their role in the conviction of a murderer and subsequent pursuit of the death penalty, the discharge of which opened the show.  In Bones, it was the main character (Booth) who shot and killed a perpetrator in a return of fire during a gun fight.  In both cases the characters struggled with the morality of the action – the right and wrong of their role in the death.

So how does this all relate to Matthew 10:36?  I think we are all faced with dilemmas and those dilemmas arise from within.  In the end, we make decisions affecting out lives and actions, each of which has some implication.  For my uncle, his decision to forgo the visit to Hopkins may be inconsequential, his life may be no different than had he gone.  Contrarily, his life and quality of life may be adversely affected by his decision – but how does one prove the negative?  In the case of my progression I can reflect on the decisions made throughout the course of my odyssey and should they ultimately be proven “wrong”, they were my decisions.  The same holds true for the characters, they struggle with the morality, but their struggles reflect that which is within, that which resides “in their own house”.  In each case, each situation we encounter, we are faced with decisions and where we harbor regret, remorse or question those decisions; the origin of those feelings come from within, they are our own.  The net is we are the masters of what we feel and of how we respond to that which we are faced within life.  If we question the outcomes, we must accept them as being of our own making and move forward.  While some often ask “why” with respect to God, I choose to see things differently.  I see our paradigm as the design of a higher being, the flow of which is dynamic and not “micro-managed”.  The design affords certain conditions that evolve with our inputs and reactions and again, those variables are “of our own house”.

As always, feel free to comment or you may email me at lifeabstractions@gmail.com



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