For those who follow, they possess the knowledge that my cancer has metastasized, that it has spread beyond its immediate domain into, among other places, my ureters.  The infiltration produced strictures in the ureters that prevented my kidneys from excreting the waste as intended.  The ramifications of this are straightforward, do something to open the ureters or loose kidney function.  This was a decision made in concert with Ron, my Hopkins urology oncologist following a renogram.  Last week I went in for what I commonly refer to as my ‘oil change’, the roughly quarterly change of the stents which keep my ureters functioning.  Again, old news for those who follow these writings.  The difference when I went this time was Ron informed me he his decision, a decision on a matter I introduced in the past.  Ron informed me he accepted the chair position at The University of Texas San Antonio.  I can’t say I didn’t see this coming, but was indeed a bit of the proverbial ‘dose of reality’.

My immediate reaction to the news was to make a bit of a backhanded comment, surely a mistake, but I think understood by Ron.  My comment simply stated something of a reality, an analogy comparing his move to that of some football personnel.  I responded by saying, “so you are leaving a Superbowl Champion to go to a Division III college team”, callous for sure, but in his own way Ron responded with his boyish smile and “yes”.  I then added, in some way trying to get my foot out of my mouth, that Cornell had a hockey coach, affectionately named ‘pops’ and who is responsible for coaching the only undefeated NCAA championship hockey team, moved to the NHL and then returned to the college ranks, to a division III school where, in two-year he took the team to prominence as a division I school.  Completing the analogy I told Ron that in my view, if anyone could take a ‘division III’ hospital to ‘division I, or better yet, the superbowl’, it was him.  Once again he smiled and it was clear all was well because of all the things I sensed from him, I sensed he was very happy with the decision and very happy that in some ways I saw the positives with that decision.  It was at this moment Ron shared something with me, something that astounded me really, he said I was the first, outside his immediate family, whom he told the move was possible.

As one can imagine Ron’s move presents a new paradigm and new decisions for me.  The timeline for his move is slow, but one I’m sure will accelerate in short order.  As Ron explained, things will go as follows, he will stop seeing new patients’ the beginning of November, discontinue performing procedures on existing patients and ‘handing them off’ in early December followed by his cleaning out his office December 18th.  I must say I was somewhat relieved that he said he thinks we should do another ‘oil change’ before he leaves, interesting because we both know doing so is on the very early end of the range for the procedure.  We both agreed that being the best option and I think we both knew why.

I am now left with a decision, something I find terribly challenging, but made easier with some thought.  Initially I told Ron I didn’t see myself following him to Texas, that I didn’t have people there like I do in Maryland, that it would be a considerable challenge to work out treatment in San Antonio. The a wonderful thing happened, something I hadn’t expected but which shed new light on the situation; my uncle and I returned to the house to find my aunt and father talking to my uncle who lives in Sherman Texas. What was the new light, it seems Sherman is only 300 miles or so from San Antonio and, for all intents and purposes, my cousin is retired and would be available to make the trip with me.  It seems providence found another incentive to follow Ron; the opportunity to get to know my distant and infrequently visited relatives.  Intersting how these things evolve, how life can indeed bring light into a dark room.

Happy reading, happy thoughts and happy trails.

As always, feel free to comment or you may email me at



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