I’ve been riding but not writing much, and it’s not because I’m having a great time doing all sorts of fun things/too busy to write. Last Friday, we got word that my wife’s breast cancer had returned, for a 4th time. We had a feeling we weren’t done with this battle; family history is terrible, with her Mom and two sisters dying from breast cancer (the last one just two weeks ago!). For Karen it’s been more of a process than anything else; Karen seemed able to take it on each time it came at her and win each battle.

The news Friday was pretty devastating. You don’t want to hear the words “Stage 4/metatastic”, & “triple negative.” The cancer is no longer confined but is now running loose. It was discovered by a routine scan, a check to make sure nothing was amiss after her last surgery back in 2016. They found a small spot on one of the lungs, small enough they gave us the option of waiting a couple months and seeing if it actually grew, or doing a biopsy (which would be difficult due to its relatively small size). And we’re thinking, we didn’t get this far by waiting and doing nothing!

We’re waiting for the details of pathology report, the all-important genetic testing that looks for all sorts of little details that help determine severity and the best course of action. The idea that there’s no cure, that whatever we do we’re just buying time, is tough. It becomes a short term life goal of learning how to buy the most time you possibly can.

Two and a half years ago, here’s what Karen’s sister Jen, the one who died just two weeks ago, wrote in an email to friends & family. It feels like there should be a disclaimer put before it, like you have in those ads for financial companies that tell you “past performance is not an indicator of future results.” But it feels, right now, like a mixture of hope and realism, the best and the worst, somehow not feeling like there’s a contradiction between them.

Hi family and friends,

I’m thinking this might be the best way to let you all know how I’m doing every few months. The updates will conveniently align with my latest doctor visits 🙂

I went in yesterday February 4th 2022.

I found out my cancer returned in 2020.It has metastasized all over my body. They say I have 2 – 5 years to live. (but that’s the conservative doctor’s official statement to say) But I asked if I could live for 10 years. And he said, ummmm…maybe! I said how about 20 years. He gave me a flat out, “No”.
But there are always new cancer drugs coming on the market. The nurse said they might have some new cool ones to try in 5 years.

Overall, my health is fantastic! Yay! So, no immediate worries for a long time.
My doctor said, conservatively, I will be around at least or another year. I know that sounds awful, but for me it means I don’t have to worry for an entire year! I’m excited about that!

Jen’s doctors were, it seems, prophetic. She lived about 2.5 years from her diagnosis, and all but the final two months she was in pretty good shape. I’m hoping, Karen’s hoping, that those “cool new” drugs coming down the road are going to be there for Karen, that in 2.5 years they’ve made a lot of progress. That the time we’re going to go out of our way to “buy” is going to allow us to buy even more time. We’re shooting for that 10 year mark. Karen’s pushing it even further; she wants 10 years + 4 days, so it begins and ends on our wedding anniversary. I’m down with that. And I recognize that we’ll be greedy and think that’s not enough, we want more, as we close in on that mark.

But for now, I’m having a really tough time thinking there could be a day when I wake up in the middle of the night to go pee and she’s not next to me, opening her eyes and getting up after me to use the bathroom as well. Kind of a funny thing, the way you sync after so many years. Earlier in marriage she’d complain about me waking her up or snoring. Now, 43 years later, or is it 44, things have changed and hearing her snore, or if I get woken up because she’s moving around, it’s comforting. I easily go back to sleep. Things are so much better today. How can that be taken away?

Lots of crying, lots of praying, lots of trying to make sense of it. While at the same time I have to keep my concentration on finding out as much as I can about Karen’s particular cancer, the best treatments, and how to get them. I have to buy time. Time to spend with the woman I can’t imagine not going to bed with, waking up next to, taking vacations with, cleaning the kitchen, watching dumb Netflix series with, and being intimate with.

I’m not giving up on that. We’ll know more next Tuesday, when we have our first video appointment with Karen’s Kaiser oncologist, the day after her PET scan. Tomorrow will be a brain scan. Yesterday I started the process of setting up a consultation with a Stanford Doctor, Melinda Telli, who is the world expert on triple-negative breast cancers and also studies hereditary issues. A match made in heaven, hopefully to selfishly keep Karen on earth a few years longer. Somehow I have to stay strong and remain analytical and perceptive and curious through all of this. It’s going to be tough.

I’ve seen things you people wouldn’t believe… Attack ships on fire off the shoulder of Orion… I watched C-beams glitter in the dark near the Tannhäuser Gate. All those moments will be lost in time, like tears in rain… Time to die.

One of the great lines from cinema, delivered towards the end of Blade Runner, by a replicant that chose to live as human. He actually “lived”, as an android, for only a few short years, but experienced far more in those few years than 99% of us would in in normal lifespan. Implied was that Roy (the android) was “ready” to die because he’d lived a full life.

Sweeping and heroic prose, but real life doesn’t work that way.

This morning, my wife, Karen, received a message that her sister Jen, who’s been fighting breast cancer for some time, and for whom it had become a losing battle, had died. Tomorrow would have been her birthday. My wife had planned to call Jen on her birthday to see how she was doing, and say good-bye, but as things go, these two sisters didn’t talk a whole lot and Jen started shutting down a couple weeks ago. Karen wonders why Jen died the day before she was going to call her. Karen wonders why God would not want her to have the chance to say good-bye. And what is it that someone would die just a day before their birthday anyway?

I don’t think it works that way. I think, after a long and painful illness, when you’ve become dependent upon morphine to control most of the pain, there is probably some comfort to be had in no longer focusing on a “goal” but rather accepting the peace that might come from letting go. It’s really not about everyone else. It’s not about mending relationships or helping people seek closure. I don’t know when the time for that ends, but pretty sure that, for those in chronic pain, we, the family, the friends, our only job is to wipe the slate clean ourselves and allow them to move on in peace.

You hear all the stories about someone given a short time to live and yet somehow they manage to make it well past that, allowing them to see a grandchild’s birth or a daughter’s wedding or some such. I’m sure it does sometimes happen. I think my father was happy that he lived long enough to spend some times with his first grandchild, Becky. But at some point one needs to let go of goals, especially those expressed by others, and nobody should feel bad about it.

It’s rough for Karen. She lost her Mom to breast cancer many years ago, her #2 sister to the same cancer… 11 years ago? And now #4 sister, the youngest, today. And Karen herself has been through three separate instances of breast cancer, so far. Karen’s the “lucky” one (ok, actually that would be sister #3, Kristi, who’s not had cancer at all) in that she’s been pretty healthy despite it all, and no indication it’s ever spread. Ironically crossing our fingers on that one, as she went in for a routine scan yesterday and they did come up with a very small spot on a lung they want to take a look at, so small that it’s difficult to biopsy. She was asked if she’d like to just wait a few months and get another scan, see if it grows, vs have a biopsy now. To the doctors, they don’t see a whole lot of difference between the two options, since the spot is so small (they don’t see it as much of a threat regardless of what it is). But Karen’s always chosen more-aggressive treatment options, which has paid off so far, and we don’t see a reason to change strategies today. Near as we can tell, Karen’s end-game is not in sight, and I’m hoping it stays that way for a long time to come.

But when that time does come, for me, for her, for anyone else close, I think I’m slowly learning how best to deal with it, especially for the person moving on. But yeah, I’m going to miss Jen; we communicated often through Facebook, and it was tough knowing what was coming and dropping her an occasional note that went without answer. For the last few weeks I’d tell her what was going on in my life and ask if there was anything I could do for her, but stopped asking anything of her at least 6 weeks ago. I’d check Facebook Messenger each day to see if she’d checked in, just to know she was still alive. The last time looks like about 12 hours prior. I have more questions than answers, but I’m comforted knowing that she died with her two kids (early 20s) at her side. She had expressed earlier to me that she wanted nothing more than that. She didn’t want visitors, and I think I now understand that. She’d probably had a lot of time to think about it. She could choose her own time and it had nothing to do with closure or loose ends or obligations others might have thought to be “normal.”