An Unwanted Journey: Day 1013 - Eight-hour day

It was Robert Owen who coined the slogan "eight hours labour, eight hours recreation, eight hours rest" during the early 19th century in Britain. Today, many of us occupied in knowledge work will typically be paid on a 37.5-hour work week. That doesn't address how many hours are actually spent doing work, but I suspect most knowledge workers in general still don't completely balance 8 hours work, 8 hours recreation, and 8 hours rest.

Knowledge workers are said to outnumber all other workers in North America by at least a four to one margin. We benefit our employers by improving the company's business intelligence or intellectual capital. It would be wonderful if it could be said that we do so primarily by a balanced lifestyle in which rest and recreation are as important as time spent directly on business activities. The argument here is that rest and recreation dramatically improve productivity, that perceptive employers understand this, and that workers are correspondingly motivated to keep their lives in balance.

In fact, I think an argument can be made that this is happening. Speaking from a narrow personal perspective, some of the most productive and valuable people I see in business are those for whom balance between labour, recreation, and rest is not just a goal, but a critical pillar of their lives.

A lot depends on definitions, of course. One can define recreation, for example, as spending time on the Internet. But if you're doing so as a course of study, say to gain a certification relevant to your work as a professional knowledge worker, can we really call that recreation? Or if you're checking out your Facebook notifications from your office computer, can we really call that labour? Or if you're checking business email or other computer processing in the middle of the night, can we call that rest?

There will always be tension between laudable goals and the pressures of the moment. But today is dedicated to workers, specifically workers taking a day off work.

And there you go, a blog entry in my Unwanted Journey thread in which the word cancer only appears once!

An Unwanted Journey: Day 1011 - Why a Journey?

It's not about criticizing other people. But how often do you hear about the untimely death of a colleague or friend or family member, pick up the obituary notice and read, "XXX lost his/her battle with cancer"? If once, maybe dozens of times.

Cancer kills. There's no doubt about that. And for those of us diagnosed with cancer, there are definitely times when we feel in a fighting mood, when we choose to employ metaphors of battle and images of violence to depict the struggle in which we are engaged.

But I made my wife promise me recently that when I die I want the announcement to be different. I don't want my death to be announced as a loss in a battle to cancer. Instead, I'd like the announcement to read something like this...

"Don died yesterday after living a full life for xx years. He died at peace, with his family and friends close by, saying farewell and grateful for the journey he has completed. Cancer was part of that journey, but not nearly as important as sunshine and happy days, the wonderful years of love and growth with his wife and sons, work that he accomplished with pride, friendships that lasted a lifetime, and at peace with himself and those that mattered most to him. In this wild and wondrous universe, his journey is complete, like a pebble dropped into a pond and sinking to the bottom, but with waves rippling indefinitely and extending in all directions. And, it's all right."

When I was diagnosed with colorectal cancer and decided to blog about my experiences, I had very little time to decide on the metaphor to carry me through and characterize what was happening. I choose the metaphor of a journey. That was partially because I wanted to maintain a sense of optimism, the hope that cancer was not necessarily an acute and immediately terminal diagnosis, but something that might be chronic, unwanted to be sure, but something that accompanied me as I moved forward with my life. And then I read something that struck a chord that resonated with me - “You will choose courage and hope. Though the journey was unwanted, you will choose the way you face the future and your inner spirit will prevail.” - from the preface by Cheryl Edwards to the book The Intelligent Patient Guide to Colorectal Cancer by Michael Pezim and David Owen. It worked.

This morning, as is our custom on Saturdays, we got up early, drove each of our sons to work, then headed over to Starbucks, then down to the Kitchener Market for veggies, fruit, chocolate and marble rye bread. As we traveled along our familiar path sipping coffee, nibbling on a raspberry scone or loaf, and listening to CBC Radio 2, we heard a tune and lyric which reinforced the metaphor I have chosen - the Traveling Wilburys 1989 classic End of the Line. I hope my own "end of the line" is still a long way off, but even if it is closer than anticipated, like the song says, "It's all right."

An Unwanted Journey: Day 1010 - Scarred and Proud

Advanced colorectal cancer with metastases to the liver. But instead of a 55-year-old man, the diagnosis was for a 22-year-old female graduate student named Erika Kratzer. You can find her story here. She is also in the tasteful photograph accompanying this entry and the cover model for a calendar called 2008 Colondar, a fund-raising venture for The Colon Club.

Friends and acquaintances have suggested to me recently that my shirtless bathing suit days will probably be over now. After all, I have the long vertical scar from the low anterior resection from 2006. And this year I'll have one, possibly two, more scars from liver resections. But as I browsed through the photographs of the models for 2008 Colondar, I'm wondering whether shirtless is the way to go.

True, I don't have the body of these models, but like them I think I will eventually see my scars as a badge of courage and perseverance. Cancer takes so much away from us, not just physically, but emotionally, in lost opportunities and sometimes loss of self-esteem. But for however long one survives, the journey with cancer can also lead to self-awareness, trust in one's own resources, acknowledgement of the goodness and skill of others, and a sense that our scars are better than tatoos can ever hope to be in portraying the person within.

Remember the scene in the original Jaws where the characters played by Robert Shaw, Richard Dreyfuss and Roy Scheider compare scars? It's all about pride and fear, inextricably linked. Something like what colorectal cancer scars tell us...but to do that, you need a storyteller and someone willing to show us their scars. Come see me same time next year. Maybe I'll show you my scars.

An Unwanted Journey: Day 1009 - What Can Go Wrong

Blood tests, EKG, X-rays, consults with pain specialists, the anaesthesiologist, the pre-surgical nurse and so on. Roughly 3 1/2 hours of answering questions, filling in forms, hearing all the things that can go wrong during a major surgery like liver resection, discovering that I'll be in the intensive care unit for about 2 days before being transferred to the surgical floor, that I'll probably need blood transfusions during surgery...it's all a little overwhelming today.

I now know when to stop taking my vitamins, stop drinking alcohol, stop eating, stop drinking water, what medications to take with me, when to bathe, what to take with me, what not to take with me, the privacy policy and access code for my wife, how long I'll be in hospital, where the scar will be on my torso, what all the machines, lines, catheters, and pain meds will be, the importance of using the inspirometer and wiggling my toes while confined in the IC unit...did I say it's all a bit overwhelming?

And then I went back to work for the afternoon. Not that I was able to concentrate effectively on the tasks at hand. All I could really think about was the image of how a man can be transformed into an octopus of wires, tubes, and lines.

While waiting for each new phase in the consultations, I tried and eventually succeeded in finding the wireless access in the hospital, only to discover that what was free 2 1/2 years ago now costs the patient about $9 a day, $20 a week or $35 a month. And then there's the additional costs of phone and television access (which you can't have in intensive care, for fairly obvious reasons).

It was a wake up call. Not that I haven't been paying attention and aware about how serious this business of surgery truly is. It's just that all this pre-surgical business was like someone shaking you, throwing water in your face, or pinching you as you began to doze off. This evening it's very, very real!

But it's also slightly unreal. No matter how many times I'm asked if I have questions about the surgery or the pain meds or the general anaesthesia, there really isn't anything optional here, other than whether I want regular TV or prime TV. The surgery is something we have to do and basically all I can do well is to show up hoping for the best possible outcome. It's like being asked if you have any concerns about the sun coming up tomorrow morning or about the rain and thunderstorms we expect in the region tonight.

The reality is that the preparation is necessary. Patients need to know what will happen to them. The hospital staff needs to outline what can go wrong, even with good lab results. And I just need to get from here to there.

Two weeks from now, I'll be recovering in the ICU, happy to see my wife's face and thinking about whether I will order the television service for my semi-private room in another day or two.

An Unwanted Journey: Day 1004 - Disabled in real life

"We're OK now...it's better than the alternative." -Dan in Real Life

As the Olympics draw to a close, I'm thinking about how much of the Summer Paralympics in Beijing we'll see on TV. CBC has recently been granted permission for a new digital sports channel - CBC Sports Plus - which is slated to cover the Paralympics beginning 6-Sept-2008. Unlike the Olympic coverage, though, it seems we'll get only 2 hours of coverage on each of the 6, 7, 13, and 14 of September on CBC English TV.

I guess the disparity reflects what the general public wants to see. I get it.

But this year, as I face further surgery and chemotherapy beginning 10-Sept-2008 - right in the middle of the Beijing Paralympic Games - I'm reflecting again on what it means to be disabled. In the United States, for instance, cancer might easily be included under the definition of disability used by the Americans with Disabilities Act (ADA). In Ontario, we have the 2001 Accessibility for Ontarians with Disabilities Act (Ontario Regulation 429/07). Cancer Care Ontario is one of the customer service organizations participating in the ODA accessibility standards. There is even an online accessibility plan for our regional hospitals and cancer centre describing efforts to improve services to persons with disabilities.

Most of the time, accessibility in this context implies access to health services like cancer care for those with obvious long-term physical or mental disabilities. Cancer itself is one of those grey areas in defining disability. If the effects are long-term, then a patient with cancer might be considered disabled.

But all the debate is, when considered at a personal and immediate level, largely academic. Whether long- or short-term, when you face cancer treatment, you "feel" disabled. No matter how good the medical and support services, no matter how reasonable and accommodating your employer is, no matter how good your short- and long-term disability insurance coverage...you're still faced with losses and setbacks not only with your health but with your family life and your career.

As the lead line says, it's still better than the alternative. Nonetheless, I am now entering a second period in my life when cancer is interrupting my career and turning me into a person with disability. There are moments, despite my best efforts at grace and grit, when those other aspects of facing cancer hurt. My physical limitations over the next 6 months will be quite significant. I'll be almost useless at home in helping around the house and yard. At work, I've got to transition responsibilities to other people and hope that I can still do some knowledge work that will make a difference.

But there's really no avoiding the fact that cancer is about so much more than the risk of premature death. Yes, I'm revising my will. I'm reviewing my life insurance policies and doing estate planning. But I'm also backing off professional volunteer work, parking professional certification and other related studies, and turning over projects to other colleagues.

Every meeting I attend these days, I find myself wondering whether I'll really be able to follow up recommendations and action plans and, if so, for how long and how effectively. Sometimes I wonder about if and when I will feel productive again after surgery and during chemotherapy. And, when I'm truly honest with myself, I even wonder sometimes whether colleagues are treating me with "kid gloves" because they feel sorry for me.

Don't misunderstand me. I am appreciative of those who care and do what they can to help. And I certainly understand why transitions must be made. But it still hurts. I think I'm gaining some perspective on what everyday life is like for people with disabilities.

An Unwanted Journey: Day 1000 - Life is a chronic condition

I think it's time to shift perspectives.

Receiving news that I am now a Stage IV metastatic colorectal cancer patient, after having many months of a "no evidence of disease" status, has been really hard for me. I keep looking at the prognoses and thinking about so many other MCRC patients before me whose outcomes frighten me. Nobody is talking about a cure anymore, although occasionally the surgical option is described as the only "curative option" available.

But today is 1000 days into my "unwanted journey" and despite the set backs and problems, that's still 2 3/4 years since my original diagnosis. Apart from a cure, the next best option is to consider my cancer as a chronic condition that merits occasional aggressive therapy. I can't say that the prospects of more surgery and chemotherapy are attractive, but I have to admit that I haven't been treated for cancer since late September in 2006. I'm feeling pretty good (although I do require more rest then before treatment) and there are those days when my digestive system really does act up. But the bottom line is I'm working full days and haven't had even a single sick day off of work since I started my new job on December 3rd, 2007.

In other words, life with cancer has become a new normal for me. Yes, my life expectancy is shorter than I would like. Yes, I'm feeling older and less resilient than I would like. But I can do a lot of things, some of them really well! I'm heading into a period when I know I'll feel very weak and unable to do many things, but I still have good reason to think I'll survive this next stage in the treatment process.

My cancer is chronic. But so too is life. Death is inevitable and decline is irreversible anyway. So why not think of this next part of the journey as simply another challenge, another opportunity to grow and to make the most of the situation. It may not be simply a matter of "putting on a happy face", but perhaps it is simply a matter of grace and grit.

That's something I can do.

An Unwanted Journey: Day 0999 - Mixed Feelings

It was Thursday, November 24th, 2005 when the gastroenterologist informed me that I had a cancerous tumor in the sigmoid colon. If I count today, then that means that tomorrow will be the 1000th day since I received the diagnosis.

That's worth celebrating. I remember how I originally chose to have 4 digits in the daily count...it was a decision to remain optimistic about my chances of surviving. So much has happened since then, but I'm still kicking. Definitely, 1000 days is a milestone.

The only reason why I have mixed feelings is because of the recent diagnosis of metastasis to the liver. It's almost like getting the original diagnosis. But this time, my reaction is less one of shock and more one of disappointment and frustration, disappointment because I really thought my last CT scan would be negative, and frustration because I have been doing everything I should be doing as far as medical follow-up is concerned.

One thousand days strikes me as another good interim goal. Without good surgical outcomes, that goal will be difficult to achieve. But with reasonable surgical results, and continuing aggressive chemotherapy, I think I have a good shot at another 1000 days...minimum.

An Unwanted Journey: Day 0996 - More Farewells

Leroy Sievers died Friday. He was 53. Randy Pausch died just a few weeks ago at age 47 of pancreatic cancer. A colleague from work died of cancer less than a week ago. She was 59.

I followed, as much as possible, their efforts to live and die well. They have inspired me at times. At other times, I have used them to put my own struggles with cancer into perspective.

Today, at this particular moment, I feel a little lost. In just over three weeks, I will be undergoing surgery for metastatic colorectal cancer to the liver. The surgeon will be performing a liver resection to remove a portion of my liver with two lesions. The plan is to do an initial surgery, followed by chemotherapy, then restaging of the other lesions on another part of the liver with the goal of another resection, followed by yet more chemotherapy. The plan is aggressive and frightening. But even more so in the context of the deaths of those whose stories I have been following.

As my wife reminds me, comparisons are not always useful. I acknowledge that intellectually, but emotionally I feel bereft. Leroy's heart-on-his-sleeve daily blog entries were especially helpful to me. There were many times when what he wrote resonated, and now more than ever (Leroy was battling metastatic colorectal cancer). Wondering about whether it was worthwhile to buy new pants or shoes. Appreciating the heroics of those providing the support network in his life. Marvelling at the medical technological wonders and treatment options while still suffering their side effects. Thanking those who commented on his entries with stories of their own.

I will miss Leroy's daily musings deeply.

An Unwanted Journey: Day 0984 - Pure Presence

I'm not really there yet - here that is.

In fact, I'm still ambivalent about being purely in the present, fully engaged in the here-and-now. Why? Partly because an element of my recovery from treatment the first time was about gradually recovering a sense of the future and of the importance of planning for days, months, and years ahead (see Be Here Now ... I don't think so). I saw the movement from concentrating simply on one day at a time (and even one hour at a time while in hospital) to a growing sense of optimism about the future as a sign of health.

Now, with recurrence not just a probability but a fact, I'm thrust back into the present, not by choice, but simply by circumstance.

Too many people, in my opinion, sanctify "living in the present" and needlessly denigrate human planning and thinking about the future. Clearly, there is some kind of balance to be achieved here. But cancer makes achieving balance that much harder. In moments of melancholy, I truly feel like the future is being stolen from me, that there is something "personal" about all of this, that the injustice of it all warrants an agonizing scream for fairness. Obviously, those thoughts are not especially healing or useful. But they are part of me.

And then there are the people I love. At times, living in the purely present seems like a betrayal or failure of those I love. Sure I may feel more at peace with life, sickness, death and the universe, but that doesn't help my business associates, my immediate family members and close friends. In fact, sometimes it seems like avoidance, a simple failure to participate in life.

It's not all that bad, of course. If balance is the most appropriate metaphor, then I just have to get back on the bicycle and "feel" my way forward. Like so many things in life, facing recurrent cancer (at least psychologically) is about finding equilibrium again.

And in the spirit of getting back on the bicycle, I think I'll go mow the lawn...

An Unwanted Journey: Day 0983 - Getting Ready and Melancholy

It's been a week since I've written anything on this unwanted journey thread. A busy week, working hard, doing normal, everyday things with my colleagues, my wife and my sons. But never far from my mind is the realization that it won't be that long until I gather my hospital gown around me, pull myself onto the operating table, answer a few standard questions, receive the anaesthesia, and then awaken to nurses asking more questions.

Like a pendulum, I swing between wanting desperately to continue with the normal routine and thinking that I need to get things in order...just in case things don't work out during surgery. Today, for instance, my wife and I revised our wills. But yesterday we also visited Picard's Peanuts in St. Jacob's, the LCBO in Waterloo and other destinations essential for preparing for next weekend's annual trip to visit with family at their cottage on Taylor Island in Lake Muskoka, one of the highlights of the year for us all.

Today, I rummaged around my library for my unread book on Drawing on the Right Side of Your Brain, purchased some etching pencils and a pad of drawing paper and started thinking about overcoming my life-long aversion to drawing. Yesterday, I visited Chapters in Kitchener to pick up another book by Josh Waitzkin, The Art of Learning: An Inner Journey to Optimal Performance, after having watched the movie about Josh's early performance as a child prodigy chess player - Searching for Bobby Fischer. I reviewed Pocket PC software for chess and considered re-igniting my childhood and teen love of the game.

Maybe I'm a little crazy. But the tug of the future and of things I'd like to do and learn is battling with the urgency of imminent surgery and chemotherapy and the possibility that, this time, cancer has the upper hand. Randy Pausch called it the "elephant in the room". An apt metaphor, I suppose. But it's also like the shadow following my every move, the pop-up reminders in Outlook, and the questions in the eyes of family and friends when we meet on the street - "How are you doing?"

There are so many things I want to do and learn. I've always been a little odd that way. Mastery isn't as important to me as opportunity to learn something new. Being the expert has never been as significant a draw as knowing something about many things. But now, I'm becoming knowledgeable about things I'd rather leave to other people - what it's like having multiple surgeries, what do multiple courses of chemotherapy feel like, how do you find a vein in the crook of your elbow when scar tissue begins claiming more and more territory.

And so, I find myself saying "No" to some learning opportunities simply because I don't know if or when I'll be able to apply the learning. I find myself thinking about books and software and hobbies which yield quick returns on an investment of time and energy, that don't require more than I can give. I hate that!

I'm not pulling out my guitar these days and practicing. I'm not getting up early and studying SQL Server. I'm not learning French. I'm not thinking about certifications.

On the other hand, at work and at home, I feel more present, more in the moment. This can sometimes be very valuable and worthwhile.

I'm not depressed, but I do feel melancholic.

An Unwanted Journey: Day 0975 - Thank you, Randy Pausch

I've mentioned Randy Pausch at various times in this An Unwanted Journey thread (14-Jun-2008; 16-Nov-2007). Randy died Friday from complications of pancreatic cancer at age 47.

Perhaps it goes without saying that Randy Pausch made a difference for me personally. I've watched his lecture Really Achieving Your Childhood Dreams (on DVD from Carnegie Mellon University) and I've read his book The Last Lecture. And I'm absolutely certain I'll be watching the DVD and reading the book again. Both are within easy reach as I write this blog entry. Almost daily, I would also visit his web site to read his updates, comparing notes, so to speak, about cancer and our respective battles.

One of the benefits of the Internet is the sense of virtual community and connection. True, it's not the same as an actual relationship with someone else, but it can provide a sense of catharsis and identification.

With Randy Pausch, there was a shared passion for information technology and the entertainment industry. With Leroy Sievers, there is a shared love of the written word as well as the shared experience of metastatic colorectal cancer. But, true be told, I am almost ashamed to admit that I also turned to these two men because their prognosis was worse than my own. Doing so put my own plight into perspective.

Almost ashamed, but not quite.

We all need reality checks and comparisons with people both better off and worse off than ourselves. We need perspective. We need other voices reminding us of what is truly important.

And so I wish to thank Randy Pausch, not just for his lecture and book about living and dying well, but for being a counterpoint to my own life and battle with cancer. I am truly sad to have lost the touchstone he provided me and so many others.

An Unwanted Journey: Day 0974 - Strange Comfort

I've truly enjoyed this week of vacation with it's unscripted day trips.

Yesterday, for example, we dropped my wife off in Elora to visit the shops while my youngest son and I visited the Elora Quarry, something which, I am ashamed to admit, we had never done in over 30 years living in the Waterloo Region. As we hiked around the quarry and took our mandatory photographs, my son and I speculated on the evolutionary history and industrial history responsible for the formation of the quarry.

Later, at the Grand River Raceway overlooking the racetrack and eating some pub food after losing money at the slots, all three of us talked about some of our ventures this week, settling in on the trip to the ROM, the dinosaur exhibit and the show Darwin: The Evolution Revolution.

We speculated on how mind-boggling it was to think about the stretch of recorded human history, much less the time since the last ice age when everything characteristically human has occurred (such as agriculture, the chief visual of the previous day's trip to Bayfield and Grand Bend), except fire and cooking. And then, you start going further back into the evolution of the mammalian species, further back still to the dinosaurs, back to the evolution of multi-cellular creatures from the unicellular "soup", back to the formation of our own solar system, itself formed from the remnants of yet another solar system before that - all of which was necessary to the moment in time we enjoyed together.

I shared something with my wife and son then, something which I guess I might as well call "a strange comfort". It's the idea that as one contemplates life and death, particularly one's own individual life and death, there is a strange comforting realization, derived from the vast stretches of evolutionary time, that my particular life doesn't matter. Then, juxtaposed to that realization, is the opposite realization that just this very moment with the reality of loved ones beside me having fun together, it matters very much.

But it's only when the two are held together in a kind of split-screen reality that the strange comfort occurs. On one half of the screen is a visual representation of the evolutionary vista of our solar system, life, and the geological shifts responsible for the creation of the Elora Gorge. Then, on the other half of the screen, are moments from one person's life, moments of making a difference by personal effort, whether that moment is eliciting a laugh from your son, solving a problem with understanding a piece of software for a customer, writing a meaningful blog post, painting a landscape, cooking a meal for the family...and so on.

One gets comfort and meaning where one can when contemplating cancer or any other life-threatening illness. My strange comfort - now so named - is the realization that my life both doesn't matter much in evolutionary time and yet matters very much for the ripples which I create in other people's lives.

An Unwanted Journey: Day 0973 - Cancer Talk

So why bother blogging about cancer at all? Isn't it better to simply shut up, do the treatment, put on a happy face, and hope for the best?

Maybe. It depends on who you ask.

If you ask those who blog about their cancer, chances are you're going to get responses asserting the therapeutic value of blogging. Today, for example, four regular cancer bloggers are holding a so-called "Cancer Bloggers Reunion" at Cancer Lifeline in Seattle on the topic "Why We Blog". But that's only four people among the estimated 35,000 bloggers in the United States alone who blog regularly about their battles with cancer, the medical system, friends and family, sex and blogging itself.

Cherie Black, a reporter with the Seattle P-I, has an article online today - "Blogs help cancer patients cope with disease". In the article, she talks about those women who will be participating in the cancer bloggers reunion today. They blog for a variety of personal reasons; as a soapbox, to get help from others with rare forms of cancer, to encourage others newly diagnosed, to use humour for therapeutic benefit, and so on.

I think I appreciate why they do this.

My blog provides an opportunity for me to research and compile that research into easily digested short subjects. It allows me to communicate to a broad audience with a single message. It provides a catharsis. It simply publishes news of how treatment is progressing to family, friends, and colleagues. It offers a means of communication and social networking when other means are either too difficult, time-consuming, or draining.

I blog because I can.

Sometimes that means I'll slip into a zone of self-centeredness, something alluded to today in Leroy Siever's blog "It's Not All About Me". After all, cancer affects just about everyone you talk to these days. So, occasionally, those who blog will naturally get "blogged down" by their choice of coping. I say, "so be it."

Some people will choose silence, a grin-and-bear-it attitude. Some will choose support groups in their neighbourhoods. Some will choose a few close friends. Some will choose conventional media. Some will choose new media like blogs. The point is, different people will choose different avenues of coping and dealing with cancer.

The great thing about cancer blogs, though, is that they provide patients and care givers with options, not just about therapy, but emotional responses, about appropriate and inappropriate behavioural responses, about everything connected with the experience of cancer.

Cancer talk may not be the only way to cope. It may not even be the best. But it is one way that works for many of us.

An Unwanted Journey: Day 0971 - Being Selfish

"You either die a hero, or you live long enough to see yourself become the villain." - Harvey Dent, The Dark Knight

...or maybe both.

It's one of life's ironies that, difficult as it is to follow the maxim "Know thyself", it is both more difficult and far easier for other people to know you.

Why easier?

If you've read Malcolm Gladwell's Blink, you will have understood the concept of rapid cognition, the idea that one can come to an accurate impression of another person or object in the blink of an eye. With a few exceptions, it's safe to say that these fleeting impressions are not only accurate, but will last for a very, very long time.

This week, my wife and I met with a social worker at the Grand River Regional Cancer Centre to discuss counselling needs for me and my family in the wake of the diagnosis of metastatic colorectal cancer (MCRC). To put it quite bluntly, I was concerned about the extent to which I should become "selfish" about my own needs and the needs of my wife and two sons. Clearly, there was a personal sense of guilt surfacing as I struggled to say "No" to some people.

The social worker listened very carefully and summed up her impressions this way: "I've known you for less than 20 minutes, and you are not a selfish person. That much is very obvious to me."

Now, either I pulled one over on her, or the Blink phenomenon was at work.

This morning, as my wife and I mused over cafe late and cafe mocha at Starbucks, we reflected on our recent experiences. Later, as we walked to the car, I asked her, "We've known each other for 37 years now. Do you know me?"

"Better than anyone else in the world," was her response.

And yet our mutual attraction - which has lasted all these years - began in the blink of an eye, confirmed by the most fleeting of initial conversations. Those impressions were accurate and lasting.

So why is it more difficult for other people to know us?

For other people, there may not be the luxury of a clear and clean first impression. Alternately, there may not be the opportunity for long-term exposure and in-depth conversations and mutual experiences to confirm or deny the "measure of the man". But such individuals will still hold to preconceptions, presumptions, and expectations that make a reappraisal virtually impossible. In other words, what they see is not what is really there.

This happens with family. It happens with childhood friends. But it rarely happens with lifelong friends or with individuals with whom you have consistent, important relationships. As Gladwell will admit, sometimes the Blink experience is, simply put, incorrect and requires reappraisal. In those cases where first impressions are incorrect, what is needed is long-term interaction and a willingness to cast aside preconceptions.

So, as I approach another round of surgeries and chemotherapy, and as I deal with my sense of guilt about becoming more self-centred and preoccupied with my own needs and those of my family, I need to remember this. Both those who know me well and those open to the Blink experience confirm that I am not intrinsically selfish, but that I need to become more selfish if even for a few months. Or however long it takes.

The roller coaster ride that is cancer is just as much about issues like this as it is about medical treatment.

An Unwanted Journey: Day 0969 - Our New Treatment Plan

My wife and I met with the oncologist today who specializes in liver surgery.

On the diagnostic side, he confirmed that there were three, not two lesions, two on the left lobe and one on the right. It is the one on the right that is the difficult one since it sits adjacent to both the biliary duct and the hepatic portal vein.

So, among the several options we considered, I chose what I think offers the best survival odds. It’s a two-stage surgical approach with chemotherapy after the first and second stages. Currently, my first surgery will be on 10-Sept to cut out a large chunk of the left hepatic lobe, removing the two lesions that are more readily dealt with surgically. After about a month, I’ll start chemotherapy with Avastin and FOLFIRI. That will take approximately 12 weeks, if there aren’t any complications. Then, we’ll restage the remaining lesion to see if it has shrunk enough to allow a second surgery on the right side of the liver. During the restaging we will also be checking to see if any further lesions have developed.

During chemotherapy, we’re hoping to have some liver re-growth on the left side so that if and when we can do the right side, there will be more liver function available in what liver tissue is left. Unfortunately, the chemotherapy will almost certainly damage the liver, making surgery difficult at best.

So…the news overall isn’t great. But we have a plan, a very aggressive plan.

An Unwanted Journey: Day 0967 - Cancer, Chocolate, Fruit and Wine

That may well become my new mantra over the next few months.

Yes, cancer - that's the reality check. MCRC (metastatic colorectal cancer), to be precise.

Chocolate - life is so much sweeter with the end product of grinding cacao beans into a paste (thanks to my niece and family for bringing along tasty treats as a gift today - we enjoyed bits and pieces all the way back to Kitchener from Grimsby; thanks to my friend, John, for a full box of Xocai nuggets; and thanks to my colleague for some hard-to-find Ritter Sport dark whole hazelnut chocolate).

Fruit - making the trip to Stoney Creek and Grimsby today meant stopping for fresh blueberries, plums, and sweet cherries fresh from the trees of the Niagara fruit region. What makes it even sweeter is knowing that such treats, along with chocolate, help fight and prevent cancer growth.

And then there's wine - Puddicombe Estate Pinot Noir and Chardonnay, to be exact. Despite many years of enjoying the fruit of the vine, Puddicombe Estate Wines are new to my wife and me...until today. After surgery, of course, I won't be drinking wine for at least a few weeks - liver resection might mean an even longer hiatus from vino. And most probably, during chemotherapy, it might also make sense not to drink wine. Whatever - the rest of the time, apart from tea, I will constantly remind myself that there is no beverage with a longer and better association with civilization than wine. And do I need to say this? I am a civilized man!

Yes, cancer is an ironic reminder of mortality (ironic because cancer threatens life precisely because cancer cells have achieved a kind of immortality in the body). But what makes life so special for civilized men and women is the nourishment of good food, drink, and companions.

Today, my wife and I enjoyed visiting with family, especially seeing our grand nieces and nephews. We also enjoyed discovery of Cibo Osteria E Cafe in Grimsby, an Italian restaurant with wonderful panini and infused fruit tea - raspberry and peach for today.

So, there it is. People and passions...maybe the best one-two punch against cancer that there is.

An Unwanted Journey: Day 0966- The Knife

Some very good news...relatively speaking - I'm eligible for liver resection surgery. Monday afternoon, the surgical oncologist and I will talk about how and when it will happen, going under the knife for the second time in less than 30 months.

So why the happy mood? Well, as I choose to see it, I've just improved my survival odds by at least 300%. True, the 5-year survival rate on average is still less than 50%, but the image that keeps coming to mind is from the final scene of Monty Python's The Life of Brian (voted by many as the greatest comedy film of all time). If you've seen the movie, you know precisely where this is going.

Eric Idle wrote the song that was featured in that famous last scene - Always Look on the Bright Side of Life. The protagonist is sentenced to death by crucifixion. As all the rescue attempts come to nothing, one of the other characters being crucified alongside Brian attempts to cheer him up by singing the song. Soon, we see 140 other people being crucified all singing along.

As the anesthesia takes effect, I'll be doing my best (while counting backwards from 100) to recall this image.

An Unwanted Journey: Day 0961 - Supportive Options

It's written on their faces. It's intoned in their voices. It's embedded in their email text. People struggling to provide support in whatever ways they can.

Leroy Sievers has spoken about this in his My Cancer blog on NPR frequently - what do you say to someone with life-threatening cancer?

The answer to the question is actually quite simple - something. It doesn't matter how skillful you are, how many right or wrong things you say. What matters is that you say something. What matters is that you talk about both the situation at hand and the other things that we would talk about apart from the situation at hand. What matters is not taking the easy way out, avoiding saying something, avoiding the person, avoiding the obvious.

It's true - there may be some things you might want to avoid, but they are relatively few in number and should be obvious to someone with a modest sense of propriety. You might not want, for instance, to talk about your ingrown toenail as a point of comparison to someone with metastatic colorectal cancer. But talking about your grandmother's struggle with ovarian cancer, or about how the off-season is going with the Toronto Maple Leafs or the Toronto Raptors is definitely fair game.

Having a good laugh is always welcome. A buddy and I, for example, talked today about rules for flirting with younger women ("don't flirt with anyone whose mother is ten years younger than you are").

Another colleague related a story about his father that was perfect for the moment:

"When told that one of the options for his prostate cancer was castration and that he would never have an erection again, the father responded, 'I haven't had an erection since the Olympic Games.' His son turned to him and asked, 'Which Olympics?'"

Definitely, at the right time, humour works.

Shared vulnerability also works, again as the situation and mood dictate. Speaking of comparable situations you have experienced in your own life history demonstrates a sense of "getting it" and indicates a willingness to participate in the emotional landscape of the patient.

What doesn't work is totally inappropriate comparisons and poorly timed seques into your own emotional territory. Again, these aren't hard and fast rules so much as guidelines. A cancer patient doesn't mind at all talking to you about your own life concerns. After all, we care as much about you as about this damned cancer that's eating away at our shared time together. It's the avoidance that's key here. If you want to talk about scraping the bumper on your car, great. But it shouldn't be because the bumper is obviously more important to you than squarely facing the reality of the elephant in the room.

But with that said, the elephant in the room isn't the only reality that matters. What matters is that you're here, you've said something in an attempt to identify with me, you're present in a meaningful way, and that you haven't avoided the obvious. Sometimes, all that matters is the hug, the squeezing of the hand, the attentiveness, the phone call, the email, the prayer.

An Unwanted Journey: Day 0959 - Optimism and Realism

It's stage IV metastatic colorectal cancer with metastases to the liver.

So, it's official. The tumour board meets next Friday to review my case and determine a treatment plan. I will almost certainly have chemotherapy as a primary treatment protocol, using avastin with Folfiri. I may be involved in a clinical trial for a PET scan. And, if I am really lucky, I'll be eligible for a liver resection.

Why lucky? Because surgery is just about the only treatment currently which can speak of a curative plateau. Optimistically, I'm young enough and healthy enough with liver lesions in a location where we can seriously consider resection. But realistically, five-year survival statistics aren't great, less than 50%.

I will choose both optimism and realism - optimism because I truly believe that thinking that way improves my mental health and helps prepare me for the rigours of chemotherapy and surgery - realism because there isn't any point in ignoring statistics and general outcomes completely.

One of the strange things about today was my relative calm. My wife and I asked questions, I got some more blood work done, and then we both went back to work. Sure, we talked about some of the implications of the diagnosis, about the seriousness of the anticipated treatment, and about the uncertainties of the prognosis. But for both of us, there was a sense not of resignation, but of peacefulness which I can't really explain.

Perhaps it's because we've both been here before. We know what to expect from both surgery and chemotherapy. We know that we have a reserve of strength and the support of family, friends and colleagues. We know that our medical team is excellent. And I guess we've learned that there are no guarantees in life, that it's foolish to expect life to be fair, and that there are some things beyond our control. But what is in our control is how we react to what life throws at us.

Maybe we've learned that choosing optimism is a very realistic and sensible approach to even a life-threatening illness.

An Unwanted Journey: Day 0958 - Anticipation

What do you do when you're waiting to hear an oncologist tell you that your cancer is back?

In my case, I work, I watch television (mainly comedies and sports), I write, I read, I talk to family and friends, I kiss my wife and hug my sons, and I think...or, more accurately, I anticipate. Will I be eligible for liver surgery? Will they want to do chemotherapy right away? Will they want another colonoscopy? Will they want a biopsy?

Even more importantly, will my career take another body blow? Will I gradually get pushed to the sidelines as treatment interferes with just about everything? Will I survive for a few more years? Will I survive for a few more months?

I know...just a little morbid. Anticipation isn't as useful as some of the other strategies I use. The problem is it's the default strategy when the others aren't available as options.

Tomorrow I get some answers. Then, I'll have more questions. Then more waiting and more anticipation.

An Unwanted Journey: Day 0953 - McFadyen new head of GRRCC

My surgical oncologist, Dr Craig McFadyen, has just been named the new head of the Grand River Regional Cancer Centre. In addition, he is the regional vice-president with responsibilities for the cancer centre and the Waterloo-Wellington regional cancer program.

I am so grateful that he took a lead on my initial diagnosis of colorectal cancer, helped craft the treatment protocol, performed several colonoscopies and sigmoidoscopies as well as the low anterior resection which removed the tumor from my body, and has been actively involved in my follow up consultations since.

Although his leadership and administrative responsibilities mean that he will spend less time in surgical practice, I have every confidence that he will continue to keep abreast of the most current medical treatment protocols to the benefit of all who find themselves, like me, in need of treatment from the GRRCC.

I especially appreciate that one of his goals is to include more patients in clinical trials. As I now face the prospect of liver metastases, clinical trials may become a significant treatment option for me personally.

If anything positive can be said about the prospect of having lesions in my liver, having access to the best radiation therapy in the province, the second-best wait times for chemotherapy in the province, and one of the best surgical oncology teams leaves me hopeful.

An Unwanted Journey: Day 0952 - Profiling Treatment Options

"When patients know more, everyone benefits." - NexCura

The American Cancer Society has an interesting treatment profiler tool available for a number of cancers. In my case, the profiler I'm interested in is the colorectal cancer type: recurrent.

Liver resection is clearly the standard for the best prognosis for 5-year survival rates - 25-40%. But there are many conditions required to be considered a candidate for liver resection treatment:

• no evidence of metastatic disease other than the liver


• the primary tumor site must be completely controlled


• no major structures in the liver may be involved (hepatic artery, major bile ducts, and the portal vein) or even close to the lesions


• there must be enough healthy liver remaining to function normally


• the patient must be able to tolerate the surgical stress

So, clearly, I have a lot of questions to ask the oncologist next week about my eligibility for liver resection. But apart from that option, there are other treatment possibilities, including:

• hepatic arterial infusion (HAI) chemotherapy: drugs delivered directly into the liver, usually through a catheter and a surgically implanted pump


• radiofrequency ablation: using heat to destroy tumors, usually under general anesthesia during day surgery


• microwave coagulation: ultra high-speed microwaves delivered through a probe in cutting and cauterizing the tumor


• novel radiation techniques and delivery systems: such as Intensity Modulated Radiation Therapy (IMRT), Image-guided radiotherapy (IGRT), Extracranial Stereotactic Radiosurgery, and Selective Internal Radiation Therapy (SIRT)


• clinical trials

In other words, it gets very complicated very quickly.

While I appreciate the information Nexcura provides through the American Cancer Society's web site in its Treatment Options Report, this is only a first step. It's about gathering some useful information to be prepared when the oncologists start talking about options...at least I hope they talk about options!

But this weekend, after this bit of research, I think I'll take a break and watch the Wimbledon finals and some more CFL action.

An Unwanted Journey: Day 0950 - Lesions on the Liver

A colleague at work loaned me a book by Neil Peart called Ghost Rider: Travels on the Healing Road. At one point in the narration, Peart talks about how he had once thought, "Life's great; people suck." Then, as he dealt with loss and sorrow, he came to realize that the exact opposite was true, "Life sucks; people are great."

Simple wisdom, to be sure, but it could just as easily have come from me. It's a lesson I'm learning in spades these days as I seem to get more bad medical news. In getting the news, I am constantly surprised how random the vagaries of life are and how truly compassionate and helpful most people are. One thing cancer teaches is just how wonderful family, friends, and colleagues can be.

Today, for instance, my family physician came back from his holidays to see me in his office to review the test results of the CT scan. It appears that I have three lesions on the liver - 2 of them are 3.2 to 3.4 cm in length and on the left hepatic lobe, the other a little smaller at 1.3 to 1.74 cm in length and on the middle hepatic wing. I haven't done enough research yet to know what the chances are that the liver metastases are resectable or not, but I'm sure my medical and surgical oncologists will have something to say about that.

While I must remain optimistic, the main reason why colorectal cancer is the second leading cause of cancer death in the western world is because of liver metastases (in fact, Medline Plus goes so far as to say, "patients with metastatic cancer to the liver usually die of their disease"). Some more positive statistics from the American Cancer Society from 2006 speak of up to 25% of those with liver metastases undergoing curative resection with 5-year survival rates now over 50%. In one study, up to 71.5% survived for 5 years or more with resectable metastases.

But, as I learned when I was first diagnosed, statistics are only useful in talking about aggregates and trends. They don't help much on an individual case-by-case level. My situation could be better or it could be worse that the statistics imply.

So many questions! Can the left hepatic lobe be resected? What about the middle hepatic wing? What chemotherapy or immunotherapy options are available? What about radio-frequency ablation (RFA) and chemoembolization?

The answer to these questions will be mainly about people, people who know, people who care, people who can do something. And even those who don't know and can't do anything medically...well, they're already stepping up and offering me support. Yes, I may have liver metastases, but I've also got a lot of great people on my side.

An Unwanted Journey: Day 0947 - The Gathering Clouds

We've had several days of stormy weather in south-western Ontario. Thunderstorms at night and showers during the day. The weather seems to be resonating with what's going on internally.

Today, our family was together to celebrate the wedding of the daughter of good friends, a young woman who we've known since she was an infant. She looked absolutely gorgeous today, and we all had a wonderful time looking towards a bright future for J and M.

But throughout the celebration, there was the hint of gathering clouds in my personal and family horizon. The threat of recurrence of cancer is something that I take very seriously, knowing full well that advanced colorectal cancer is very dangerous, even when the treatment initially resulted in no evidence of disease.

Now, there is evidence of disease. My CEA levels have more than doubled in less than five months and are well into the abnormal range. The cancer centre has scheduled an appointment with an oncologist to review my CT scan with me, and my family physician is scheduling another colonoscopy.

All of a sudden, coping with the side effects of my last set of treatments has become secondary to the prospect of metastases. If the recurrence is in the bowel, then perhaps we have a good shot at eradicating it. If it is in the liver or lungs or abdominal cavity...well, I'd rather not think about that too much. Yes, there are potential treatments for metastases to some distant organs, but none of them is attractive.

Until we know where the road ahead will lead, I can distract myself and make sure I'm doing now what I really want to do in my life, but the storm clouds still demand attention and preparation. If I could arrange for sunny weather, I'd do so, but it may be time to get out the umbrella.

An Unwanted Journey: Day 0944 - Poor CEA Results

Should I be nervous about a recurrence of cancer?

Today, my family physician gave me the news that my CEA (carcinoembryonic antigen) test results had more than doubled in the past five month (January to June) from 3.6 to 7.8. The CT scan results weren't back yet, but he has already requested another colonoscopy for me with my surgical oncologist and I have a follow up appointment with my medical oncologist in two weeks.

Maybe the reason for my anxiety last week wasn't entirely off the mark. As I've been looking at search results again today about CEA levels, I can't help but wonder whether I should have been more vigilant (after all, my CEA level in January was 3.6, higher than it ever was even prior to treatment). In fact, to be brutally honest with myself, what was I thinking when I was issued a follow-up CT scan and a request for extra blood work from the cancer centre last week? My family physician hadn't said anything to me about getting the cancer centre involved in my regular follow-up protocol again. So was their involvement just coincidental? I don't think so.

And so here I go again, worrying and researching colorectal cancer tumor markers instead of so many other things that I might otherwise be doing. I read about the American Society of Clinical Oncology's 2006 Guidelines for the use of CEA as a tumor marker for the recurrence of colorectal cancer at the Colorectal Cancer Association of Canada's web site. Or a case study about a woman roughly my age whose recurrence of colorectal cancer was caught by means of the CEA postoperative follow-up. I read about other people whose CEA kept going up and who ended up with adenocarcinoma in the lungs or liver, clearly evidence of micro metastases after "successful" resections like my own.

But there it is. I can't do anything, except start pestering for test results delivered in a more timely fashion. I can do some more research. I can review my medical records. Simple things like that. But probably most importantly, I can simply live my life.

An Unwanted Journey: Day 0938 - Feelings Flooding Back

I have many reasons to be happy and content with my road to recovery. First and foremost, I'm still here, walking around, doing my job and loving it, surrounded by a loving wife and two great sons, reasonably healthy, involved as much as is physically possible with my fellow IT professionals, playing the guitar again just a little...

But today, as I walked into the Grand River Regional Cancer Centre for blood tests, registered at the front desk, received my itinerary for the morning, climbed the stairs to Clinic B, waited my turn for the Blood Collection Team to do what they do best, and then wandered through the corridors back down to the Medical Imaging Registration Office and on to the CT/MRI scanning area, it hit me. The feelings all came flooding back.

I tried to explain it to friends and colleagues curious about my medical appointments today. Vulnerability, recollections of pain, uncertainty, helplessness - mostly inchoate, but clearly enough to make me feel totally fragile. To make matters worse, memory was resonating with a completely rotten week physically - rectal bleeding, restless nights with one-hour intervals between trips to the washroom, difficulty walking, a constant discomfort down below. And then a phone call from a friend who simply wanted advice on helping another friend recently diagnosed with terminal cancer.

On the other hand, there's nothing like helping someone else to get you out of a self-induced funk. It was good to offer advice and to share why someone with cancer might have a hard time reaching out for support, why sometimes you just want to be alone, and then a few moments later craving the company of someone who cares deeply for you.

Still, life conspired this week to remind me of so much that I've been trying to - pardon the irony - put behind me.

But even with the conspiracy, family members and colleagues reached out and made it obvious that they care. Those feelings were a welcome counterpoint.

Father Time

I looked across the small, round table where our paper coffee cups lay empty of the mild morning brew we had just consumed. He was looking old. A few minutes later, as he sat in the driver's seat of my new Camry Hybrid and looked at himself in the vanity mirror, he commented, "Getting old really does a number on your face."

A couple hours later, as we sat at lunch with my mother-in-law celebrating her eighty-fifth birthday at Swiss Chalet, after I had commented how she certainly didn't look eighty-five and she had responded how she certainly felt eighty-five, how using a walker to get around the nursing home and taking Tylenol 3 extra strength pills to calm the continual pain in her curving spine made her aging quite obvious to her, the best I could do was, "Yeah, but it sure beats the alternative." And she responded, "Yes, that's so true."

The day before, I smiled when a colleague spoke of someone in their mid-fifties drifting towards the sunset years and retirement, wondering if she recognized that I had recently celebrated my fifty-fifth birthday. And I thought of a friend whose father passed away before passing this milestone, a statistic of the same cancer I have apparently survived. And I thought too of three friends with whom I had sung in a gospel band, all of whom never made it past age fifty-five, two of whom were victims of colorectal cancer.

Whether it's drifting towards the sunset years and each new insult to the body or embracing the simple opportunities of time and energy still available, I guess it's inevitable that milestones and special occasions remind us of the passage of time.

Tomorrow is Father's Day. My sons are grown men now and both working all day. But they will join my wife and me in the evening for a BBQ, weather permitting, or a restaurant meal, weather demanding. I'll get a card and another reminder that time marches on, thankful that the march still includes me and so many that I love. I'll read Randy Pausch's book, The Last Lecture, about a father's tribute and legacy to his three young children with whom he almost certainly will not spend another Father's Day. I'll shed a tear or two, thankful for what I have, who makes my life so worth living, and for the hopes and dreams that sustain other fathers like Randy and me.

Water Coloured Lives

I remember reading a few novels by C.P Snow quite a few years ago. The one that stuck with me longest was his final novel, published in 1979, entitled A Coat of Varnish. It stuck primarily because of the metaphor. Our lives, our culture, our civilization, our sense of control and equanimity can often be characterized as a coat of varnish, something which implies the fragile nature of life and the thin line separating humanity from barbarism.

This week that metaphor came back to haunt us all in Canada as we read and heard about the tragedy unfolding in Calgary of a family torn apart by an apparent domestic homicide. We heard of a young man, gifted, talented, athletic, dedicated, and apparently abruptly bereft of the coat of varnish which kept his life sane. It was a story which ripped through the normal everyday news and latched onto the imagination, triggering curiosity, fear, anxiety, and astonishment. Friends who knew the young man during his school days in Guelph spoke with me and shared their obvious perplexity. And while we all struggled to make some sense of it all - usually by calming ourselves with the recognition that events like this claim the media precisely because they do not happen regularly - the stark conclusion is that the coat of varnish can evaporate with alacrity and alarming results.

This week I also listened to music which, I think, improves my life. I visited with old friends. And I read about the world's wisdom literature in a wonderful survey by Harold Bloom. All the while, my thoughts kept rebounding to the C.P. Snow metaphor, to that "coat of varnish". The music was Vincent by Don McLean, an incredibly moving and simple tribute to the life and legacy of Vincent Van Gogh whose expressionist water colours live on despite the mental anguish and suicide of the artist. The visit captured elements of simpler, less tortured lives where cancer and troubled relations scraped away the canvas protected by that coat of varnish. And the book highlighted that the wisdom we seek in reading the best of the world's literature is often ambiguous and ironic, almost never providing the solace we desire.

I may never write a great novel. I may never paint a masterpiece. I may never compose a song that inspires. I may never even know why what we hold so dear seems so vulnerable and ephemeral. But whatever time is given to me, whatever opportunities present themselves, whatever wonderful and terrible events unfold, I must hold on to the possibility of beauty, truth, and insight. As Harold Bloom put it, "We have an interval, and then our place knows us no more." The coat of varnish is a glorious thing.

The Greek Miracle...and me

It's humbling to realize how little philosophical progress has occurred in 2400 years.

I was reading today a column from Richard Handler on the CBC.ca website entitled "The non-believer's guide to death." In the article he referenced Epicurus, a Greek philosopher that I researched in my 4th year in undergraduate studies at Trent University in the 1970s, studying with a small coterie of 3 other students in a cramped office tutored by the head of the Philosophy Department at the time, Dr. David Gallop.

The course was challenging, but I did well, adding to my knowledge of pre-Christian Greek philosophy. Now, many years later, I find myself strangely attracted to those who, at least in the Western tradition, escaped myth and religion and initiated a course of thinking that led to science and philosophy now known as the "Greek miracle". At the time I was studying Greek philosophers at Trent (up to the Neoplatonists and Augustine), I fully anticipated a career teaching theology in a college or university.

But life plays tricks. The twists and turns have led me away from Christianity and theology into that most modern world of hosted software services and that most evident embodiment of western commerce, modern banking and commercial loans. Quite a ride. And yet, I find myself coming back to those long-dead philosophers of the "Greek miracle" with utter fascination and respect. How did they do it? And what about them is relevant for today? No simple answer to the first question - that will take many more years of study. But for the second question, all one has to do is do a quick Internet search to find those whose life and practice is deeply indebted to the Greek philosophers.

Handler, for instance, continues in his thought piece to reflect on the wisdom of a contemporary philosopher/psychiatrist, Irvin Yalom who was, in turn, deeply affected by thinkers like Epicurus. Yalom, in his most recent book, Staring At The Sun: Overcoming The Terror Of Death, reflects on the idea/metaphor of rippling, the notion that what we leave behind us after we die are concentric circles of influence, like waves or ripples on a pond. Plaques on walls, books, and other material evidence of our lives may stick around for a while, but ultimately what really survives is our effect on our family, friends, and acquaintances, the ripples of our character and influence.

Which is why I've decided, as I face yet another major birthday milestone, that life is too short to waste on the insignificant, the tedious, the mundane, and the negative. Although I cannot fully control the ripples emanating from my own life, I think I can choose something of the frequency and amplitude of those waves. Like Epicurus, a life of tranquility, respect, modest pleasures and honesty are where I think I should concentrate my energies. With care, concern, attention to detail, listening, and courage, maybe my immediate family, my close friends, acquaintances and colleagues will feel positive ripples emanating from my life, something which will survive this "crack of light between two eternities of darkness" (Vladamir Nabakov).

The exception, not the rule

I fade in and out of appreciation of Facebook. For the most part these days, I simply don't have time to check out what's happening with friends and acquaintances on a regular basis. In fact, a week can go by without my checking online to see what new ridiculous Fun Wall videos have been forwarded my way. Without any exaggeration at all, 90% of the Fun Wall videos I get are in very poor taste or simply wastes of time.

But this week, the percentage of garbage was slightly lower. This week, there were two videos that I really appreciated receiving. They were the exception to the rule.

Funny...really, really funny - Food Court Musical:

Inspiring...truly inspiring - Amazing 13 year old-Britain's Got Talent HQ:

Finally, because this is my blog and I can do what I like - here, at least - I'm recommending that if you like short videos and don't want to depend on Facebook Fun Wall forwards from friends and acquaintances, consider viewing 9 short films from the Cannes Festival for 2008 co-sponsored by Canada's NFB and YouTube. Here is one of the short films. You can vote and help determine this year's winner - Papiroflexia.

Vegas for our 35th

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Originally uploaded by rtfax

Vegas 2008 is all about our 35th wedding anniversary.

This morning as I write this entry, I'm sitting on the couch in our room at the MGM-Signature watching the sun come up over the Spring Mountains and the Sierra Nevada. Vegas isn't a morning town, as you can well imagine. But my wife and I enjoy the mornings, this one especially...35 years ago today we were married in Barrie, Ontario, never once imagining that 35 years later we would be planning a gondola ride and dinner at the Venetian later in the day, a visit to the Guggenheim Hermitage Museum, or coffee and cake at the Wynn Las Vegas.

The last two days have been spent mainly in the upper and middle strip of Las Vegas Boulevard, doing so much walking that our feet require tender loving care and sun screen for my balding head. We've eaten at the Rain Forest Cafe, had cheesecake dessert at...you guessed it, The Cheesecake Factory in the Forum Shops at Caesar's, played the slots, watched the fountain show at the Bellagio with Celine Dion's theme from the Titanic, My Heart Will Go On, enjoyed pizza along the boardwalk in New York, New York, purchased T-shirts for our sons at the House of Blues in Mandalay Bay, and bought a straw hat to protect that balding head of mine at Urban Outfitters. Did I mention winning the slots at Planet Hollywood while waiting for shops to open along Miracle Mile?

It's been about 18 months since I was last here attending a conference. In that time, construction along the strip has continued unabated. In fact, as we peer northward we can see the Trump tower already in place, six skyscrapers are rising up beside the Bellagio in what is euphemistically called the City Centre, and condos/time shares are everywhere. In fact, for the occasional tourist, one of the most aggravating parts of walking the strips these days - apart from the hucksters peddling "sexy babes that will come to your room" - are the other hucksters peddling free food, free cash, free shows, etc. just to take a tour or listen to a sales presentation about purchasing a time share. Apart from that, Vegas is pretty much the same place as it was 18 months ago...only bigger, flashier, and younger.

We have two full days left in our mini vacation celebrating 35 years of married life together. Thus far, it's met all my expectations and more. It's been exactly what we wanted and needed. In fact, Vegas with my wife is so much better than Vegas during a convention. Yesterday, while taking the automated walkway from the MGM-Signature towers to the MGM, some young men, obviously enjoying the midday cocktails, and travelling in the opposite direction along the walkway, yelled over to me and said, "You should marry her again!" My sentiments exactly.

Who do you trust?

Do you trust your husband? Your wife? Your children? Your parents? Your siblings? Your friends? Your colleagues? Your acquaintances? The politicians representing you at local, regional and national levels? Religious leaders? The immigrant speaking with a foreign accent and wearing those strange clothes?

Why do you trust or distrust these people?

Who trusts you?

These are difficult questions, not just because we need to clarify the meaning of the word "trust" to answer the questions (something that is usually required for any intelligent conversation), but because the answers require deep thought, honesty, and admittedly some anguish.

We may find, for instance, that someone whom we ought to trust actually measures up quite poorly on the trust-o-meter. Or we may find that we have artificially ranked someone as trustworthy on the basis of wish fulfillment more than actual performance.

An example of the former occurred to me recently when I discovered that someone whom I trusted implicitly was saying very hurtful things about me and offering unfounded opinions about my lack of integrity to someone else. When I challenged the individual, I had the distinct impression that they thought I was making more of the issue than it warranted. Unfortunately, since that time, as I've monitored the situation, I've confirmed that my original trust was unjustified. Not only did the person say hurtful things, but they have since clearly demonstrated little understanding or appreciation of things that are meaningful and important to me.

An example of the latter is the typical situation most men face when they belong to a group, a team, or an association. I say men, because some research has validated the gender difference in establishing trust in social situations, men being inclined to establish trust on the basis of symbolic associations, women more inclined to personal and family relationships. Men tend to value being members of a group, whereas women tend to value more highly the personal connections they have established directly with other people.

The situation of wish-fulfillment for men can occur when there is a disconnect between the symbolism implicit in the group and the actual functioning of the group. If you are anything like me, then you tend towards loyalty to the group as an almost instinctive behaviour. And then something happens which makes it clear that the symbol was not nearly as important as you had hoped.

The point of all this is not that it should surprise anyone that trust is critical for almost all of us, but that trust can be destroyed in an instant or the realization occur that there wasn't any justification for trust in the first place.

Trust requires finally balancing those two parts of the human brain that appear to work in completely different ways. One part is instinctive, the kind of mechanism described by Malcolm Gladwell in Blink. Here we realize that trust can happen in an instant (or be lost in the blink of an eye), usually for reasons that make sense in evolutionary terms. We look someone in the eye or observe behaviour which confirms or denies the possibility of trust. We can't ignore those intuitions, but they can be fallible.

The second part is more rational and deliberative. Here we find ourselves thinking and reflecting about evidence for trust, outside those fleeting impressions. But again, such deliberation isn't necessarily less fallible. The whole point of men having a slightly more symbolic approach to establishing trust suggests that the deliberative mind can be seduced almost as easily as the instinctive mind, merely by floating the right symbol or icon at the right time and place. What we thought was thinking turns out to be the magnetic appeal of the symbol.

But if experience tells me anything about these bicameral features of the human brain and the nature of trust it's this - don't trust either one fully. Or to put it more positively - trust both equally well. The other thing experience tells me about trust is almost too obvious to even mention; namely, there is no substitute for time, observation, and keeping tabs. Trust me...I know what I'm talking about.