On November first I went to see Paul, my medical oncologist for my quarterly checkup, which among other things, includes a ‘booster’ of Lupron and a PSA measure.  Going into the day life was incredibly busy, for both myself and Paul.  For me, the schedule included an interview with a large bank for a very exciting position.  The trip moved me forward past the fourth step of their interview process with the day to include meetings with eight executives.  For Paul, it included a trip to California with limited access to the hospital.  The meaning of all this is to say that circumstance didn’t offer the opportunity to obtain my latest PSA, a number which tends to dictate planning, and, life plans.

Going into the appointment the consensus feeling was my PSA would be lower than that of three months earlier when it was 1.8.  All indications suggested a lower number, a dramatic initial response typically correlating to extended effectiveness of the Lupron, typically  a two-year span and improving physical symptoms, things such as the ability to urinate among the most prominent. It was, therefore, more than a surprise when I learned on the Saturday following the appointment my PSA measured 4.6, a 2.5 times increase; the Lupron having ceased to work.

For those who’ve followed, you will know that once a PSA rises while on Lupron, the cancer is considered ‘hormone refractory’ and more importantly, from a statistical perspective, death typically occurs within two years of the state setting in.  For me that means I will die sometime around the end of 2014, the latest being early 2015.  The realization death is now more tangible, at a time when no one really expected the state to set in, certainly caught me by surprise.  With it many additional things become clear;  I can now count my life in terms of the number of Thanksgivings left, the number of Christmases to share, the time available to do all those necessities required to make an orderly exit from this world.

So there I am and now I begin looking at many things, first the immediate, then the longer term.  There are all the little things, big in my mind, like who will take care of my kitty, traversing to the big things, the sale of my home, finalization of my will and trust fund and to measure the sincerity of those in my life.  The latter is of particular interest because when I am gone, when my wishes are executed upon, I no longer possess direct influence on decisions since I won’t be there to participate, at least in the physical sense.   It is, therefore, critical those charged with executing certain wishes, those whom I asked to take care of kitty, to administer my son’s trust according to my wishes, to provide my son memories and guidance relative to that I may have given, actually execute, that today they say yes, but later do not dismiss the promise.

In the end, the request made of those surviving me, those in my life asked to do something for me, boils down to a matter of trust.  It is, at the core very simple, but incredibly difficult to ascertain, particularly in the absence of true adversity.  Trust, in the end, is the essence of all human relationships and when it comes to dying, it is all a person has left.

Over my life I’ve held a certain view of how to measure trust, how to measure the depth of a friendship and whom I afford the privilege of being counted as the best of the best of my friends.  As I begin my planning for the end, I decided to test my measure, to determine in whom I could place my highest level of trust, whom I might ask to execute those wishes surviving my death.  The test is simple, it amounts to a yes or no question asked with no context and totally out of the blue.  The question, “Will you do something that is important to me, very important to me”.  I learned a lot when asking this question, in some ways more than I had hoped.

Happy reading, happy thoughts and happy trails.

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



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