Self-Compassion and Cancer

Painting by Emma Connolly

I am currently enrolled in the eight-week Cultivating Compassion course offered through the School for Contemplative Living here in New Orleans.  The course leader is Dr. William Thiele, the School’s Founding Director and author of the book Monks in the World.  William went through a year-long Compassion Cultivation Training program at Stanford University in preparation to lead the local sessions.  Dr. Thupten Jinpa at the Center for Compassion and Altruism Research and Education at Stanford developed the course.  More about the course development can be found in Dr. Jinpa’s book A Fearless Heart.  Dr. Jinpa is otherwise known for being the official translator for The Dalai Lama since 1985.

The course approach to compassion convinced me to spend my Sunday afternoons for the next couple of months in the seminar setting.  Dr. Thupten defines compassion in A Fearless Heart (2015:xxii) as “. . . a sense of concern that arises when we are confronted with another’s suffering and feel motivated to see that suffering relieved.”  Also, I was intrigued that one session would be devoted to self-compassion.

The self-compassion session took place this past Sunday. In the session, William encouraged the participants to consider a personal circumstance or event that caused us to be filled with doubt and self-blame.  I was somewhat surprised that what immediately came to my mind was my stage 4 cancer diagnosis of one year ago.  In fact, the session brought me to view an aspect of the cancer diagnosis I had not discussed with anyone, but only internalized.

Last year, during the initial speculation on the primary source of the cancer, I immediately focused on my complicity in the disease:

  • As I was a cigarette smoker from the age of 10 until my mid-40s, I felt assured that I had lung cancer.  That proved not to be the case – my lungs are in great shape.
  • My general practitioners first guess was colon cancer and I immediately felt guilt for procrastinating and never having a colonoscopy despite the recommendation of my general practitioner 15 years ago.  However, my colonoscopy last August revealed a cancer-free GI system.
  • Next my oncologist ruminated that perhaps the cancer originated in my liver based on some blood test results.  I immediately then experienced the shame and self-blame of my years of alcohol and drug abuse.  However, subsequent PET and CAT scans showed my liver is free of any cancer as well.

Another exercise in today’s session was to respond to “If anything were possible,

  • What would I love to find in my life?
  • How would I want to grow as a person?
  • What would I want to offer the world?”

An immediate and legitimate response to the first question seemingly would be to deal with my health issues.  But with a bit of reflection, I thought otherwise, responding to the questions, respectively as follows:

  • for my thoughts and actions to align with a direction toward my true self
  • to prioritize how I expend my time and resources toward that alignment
  • my true self

These response make sense to me when I consider the popular Biblical adage, (Mark 8:36) “And what do you benefit if you gain the whole world but lose your own soul?”

True self has been the trajectory of my recovery for the past three decades – coming to terms with what I am truly called to be and do in all of my relationships with self, family, friends, and the world.  I cannot imagine having traveled that path without my road out of addiction.  I expect that my current health issues will provide me the same opportunities for growth and direction toward that true self.  Being self-compassionate clearly includes fully embracing those possibilities on that journey.

A New Look at Gratitude

I have posted many times before about the importance of gratitude in my recovery.  Having an “attitude of gratitude” is a platitude that I recollect hearing quite often during my 30-day detox program and in my first AA meetings over three decades ago.  I am grateful for my recovery from alcoholism, a better than expected cancer prognosis, and a strong reason to get out of bed every morning.  I touched on this concept of gratitude in my last post.  Today, a part of my morning ritual is writing down three things for which I am grateful.

In our School for Contemplative Living group we are reading Grateful: The Transformative Power of Giving Thanks by Diana Butler Bass that articulates an understanding of gratitude I find quite important.  She writes (p. xxiv):

There is, however, an alternative structure of gratefulness, one that holds out the possibility of spiritual and ethical transformation – that of gift and response.  In this mode, gifts exist before benefactors.  The universe is a gift.  Life is a gift.  Air, light, soil, and water are gifts.  Friendship, love, sex, and family are gifts.  We live on a gifted planet.  Everything we need is here, with us.  We freely respond to these gifts by choosing a life of mutual care.

I see this understanding of gratitude not from the personal circumstances of my life, but from life itself.  Viewing life, the universe, natural resources as gifts freely given is true grace.  Butler Bass continues (p. 20-21):

Gifts are not commodities.  Gifts are the nature of the universe itself, given by God or the natural order.  Grace reminds us that every good thing is a gift – that somehow the rising of the sun and being alive are indiscriminate daily offerings to us – and then we understand all benefactors are also beneficiaries and all beneficiaries can be benefactors . . . We do not really give gifts.  We recognize gifts, we receive them and we pass them on . . . We all share them.

In the Jewish tradition the Prophets held the people accountable for this gift.  For example, the Prophet Amos speaks less from the perspective of social justice, but our responsibility for the stewardship mandated by God for the earth in the Genesis creation story.

What will we do with these freely given gifts we all share without regard for ethnicity, gender, national origin?  How can we express our gratitude?  As stewards for the natural resources of our earth, how can we express our gratitude to this freely given gift that allows us to live and thrive?

Butler Bass notes (p. 22) that:

. . . if gratitude is mutual reliance upon (instead of payback for) shared gifts, we awaken to a profound awareness of our interdependence.  Dependence may enslave the soul, but interdependence frees us.

This interdependence is the very essence of what I have learned over the years in 12 Step Recovery.  To extend this interdependence to the world stage, gratitude will require us to build bridges instead of walls, welcome the stranger with the radical hospitality of Abraham and Sarah instead of detention centers, share in the bounty of resources, knowledge, and technology instead of selling to the highest bidder.  These are challenges to extend my gratitude beyond platitudes and lists.

Our interdependence is appropriate to think about as in the U.S. we celebrate Independence Day.

Having a Reason to be Alive in Recovery

Painting by Emma Connolly of Grace and me in our backyard

Over the years, on many occasions I asked “Why Me?” The question was not meant from a woe is me perspective, but from one of gratitude.  Examples include:

  • I have over 30 years of recovery from a debilitating physical and mental obsession with alcohol.  Long-term sobriety is greatly enhanced in those who remain abstinent for five years.  For many years, I struggled to even put together 30 days.  Why did I make it when so many others do not?
  • My oncologist continues to be amazed that I am doing as well as I am with a stage 4 cancer.  Last August, the prognosis was possibly death by Christmas or in six months.  Why I have surpassed these odds?

I wrote previously about the research of Kelly Turner and have since read her book Radical Remission.  A strong reason to live is one of the nine points Dr. Turner found for those who defy the normative expectation for stage 4 cancer diagnoses.  She distinguishes this reason as different from fighting to live or being afraid to die.

Her results resonate with me in my current cancer diagnosis.  In much of what I have written about cancer over the past months I note how the one-day-at-a-time approach of Alcoholics Anonymous has proven crucial in my life today.  Further, I know that were it not for my sobriety over the past three decades, I would have been dead long ago.

An exercise in Radical Remission suggests generating two lists.  The first is a list of activities one would do if they had an unlimited amount of money and perfect health.  The second list of activities is if one had their current financial situation, good health, but knew they would be dead in 1.5 years.  The “correct” answer is to have the second list overlap with the first.  I was pleased mine did.  My second list includes:

  • Take three months to ride my bicycle from Lake Itasca in Minnesota to New Orleans.
  • Emma and I take multiple cross-country road trips and spend more time exploring together.
  • I continue to blog my story as my unique contribution to share.
  • Complete two writing projects I am working on.
  • Continue gardening and working around the house.
  • Continue activity with the School for Contemplative Living and my faith community.

With the exception of the Mississippi River bike ride, I am currently working on all the other list items.  The long-distance bike ride is something that will take some creative planning.  But come September, Emma and I will embark on a two-week back roads meander reminiscent of our first trip together 20 years ago.  All of the other items on the list are what get me out of bed every morning.

To a very large extent, what I dream of doing is what I actually do. This might prove to be the answer to the “Why Me” question.  Since walking into the detox center in 1984, I have maintained a belief and hope that I have a reason to live and I have tried, quite imperfectly, to live into that hope.

Today I came across a blog post I wrote 5 years ago, long before I had any thought of cancer.  The title of the post was Living Sober Till I Am 94, One Day at a Time. The age came from a life expectancy test of some sort that I took.  But the essence of the post is having the reason to want to live that long:

 I didn’t think about how long I was going to live.  I got to be too busy living.  As we get closer to “retirement” my wife and I talk about that next part of our lives.  We will do anything but retire.  I have a bunch of projects lined up and my wife is already working on her art/consignment business  and plans with our children and grandchildren down in New Orleans. . . today I learned that my life expectancy is 94.  What I learned today seems less the accuracy of the measure but more, that living and living fully is what sobriety is about.  Had I not gotten sober at 32, I seriously doubt that I would have seen 40.  Staying sober one day at a time, the possibilities are without limit!

I am grateful and blessed to be able to live into my reasons to be alive today!

The Spirit and Mind in Recovery

A few days ago I came across the documentary Heal.  The film is about the nontraditional treatments of chronic illnesses such as cancer.  I have written before about my disinterest in the latest “miracle” cure opting instead for my oncologist’s recommendations coupled with my lessons in recovery from alcoholism and life in general over the past three decades.  But the documentary description caused me to give it a shot.

Here is what got my attention in the film.  Kelly Turner talked about her dissertation research of 1500 case studies of cancer patients who had gone into remission both with and without traditional medical treatment.  She recorded 75 different practices the 1500 individuals carried out.  She noted nine practices that all 1500 individuals held in common, as follows:

  • Radical change in diet
  • Take control of own health
  • Follow intuition
  • Use herbs and supplements
  • Release suppressed emotions
  • Increase positive emotions
  • Embrace social support
  • Deepen spiritual connection
  • Have a strong reason for living

This list got my attention.  All nine items I have either practiced for many years or began in the past year.  Examples of the latter are radical diet change and taking control of health.  The other seven items flow directly from my past three decades of 12 Step Recovery in Alcoholics Anonymous.

Another reason the list got my attention is because my oncologist and other medical folks remain amazed that I am still so active despite a stage 4 cancer diagnosis.  But when I follow my intuition in what foods are good for me to eat, when I am in community with my family and friends, when I take part in services and activities at my church and the School for Contemplative Living, when I am active in various projects, when I listen to positive affirmations and guided imagery related to cancer, to name but a few practices, I simply feel better, have more energy, less pain, and experience the peace that passes all understanding.

I know that without these practices, I will go deep into my addictions and be filled with misery and self-loathing – and I suspect that my original cancer prognosis (dead by last Christmas) would have come to pass.

Where do I go from here?  I will certainly continue the current treatments prescribed by my oncologist.  My monthly x-geva injections are working wonders.

But I also have a responsibility to act.  I often comment that a mystical truth for me comes from the Gospel of Matthew (7:7-8):

Ask and it will be given to you; seek and you will find; knock and the door will be opened to you. For everyone who asks receives; the one who seeks finds; and to the one who knocks, the door will be opened.

Those steps all require action.  Over my past three decades of recovery from alcohol and drugs, without exception, when I have carried my part of the load, I have received, found, and the doors opened.    Will I be in remission one year from now? dead? or in the same condition as today?  I don’t know.  I have continued hope based in faith as discussed by Archbishop Desmond Tutu:

. . . hope is different in that it is based not on the ephemerality of feelings but on the firm ground of conviction.  I believe with a steadfast faith that there can never be a situation that is utterly, totally hopeless.  Hope is deeper and very, very close to unshakable . . .  p. 122, The Book of Joy

This mystical truth is as valid to me and as well-tested as the latest chemotherapy or immunotherapy drugs.  The spirit and the mind are integrally linked to my being alive today and tomorrow.

 

A Quick Health Update – Keep Moving Forward!

Okra from our backyard kingdom!

Here is a quick health update.  The results of my lymph node biopsy revealed for the first time a malignancy outside of my bones.  Here is what that all means:

  • Additional testing of the malignancy is in process to determine the type of appropriate treatment.  Based on the results of the testing an alternative to chemotherapy may be the suitable treatment.
  • I will have another scan in 2 months to develop a baseline for the amount and pace of malignancy growth.  An unknown factor is how long the malignancy has been present, though the appearance seems very slow-growing.  The next scan, coupled with the possible chemotherapy alternative solutions, will determine the next phase of treatment.
  • My oncologist remains amazed that the only real downside I continue to feel from the cancer is increased fatigue.  Otherwise, I feel better today than I did two years ago.  We discussed that despite the near 100 degree heat, I am riding my bike (early and late in the day) for 5 mile plus trips and my appetite continues to improve.  (Tonight Emma got me two pieces of fried chicken from Joey K’s – marking my first fried food in a couple of months – and I enjoyed it!)

In sum, the visit to the oncologist today was one of those good news/bad news experiences.  We discussed my plans for the immediate future as I posted in my recently recast professional blog.  Since publishing that blog:

  • Yesterday I spent several hours at the New Orleans Public Library scanning microfiche of the New Orleans writer Robert Tallant.  Today I transcribed his notebook that contained early ideas for his Mrs. Candy novels of the 1940s.
  • My colleague Ana Rea and I mapped out a timeframe and outline for our mentor/mentee project.
  • Participated in an excellent discussion with resulting actions on the Old and New Testament Biblical mandates to feed the hungry, here in New Orleans.
  • And of course, irrigated the crops, cut the grass, and otherwise contemplated our backyard kingdom.
  • Tonight Emma and I began to discuss our two-week road trip we will take around Labor Day.

One year ago I was in excruciating pain with a wholly unknown medical future.  The past year exceeded even the most optimistic expectations.

Life is good and I am blessed.

 

Gratitude for the Touro Infirmary Nursing Staff

Painting by Emma Connolly

This past September I received my first x-geva injection at the Touro Infirmary Cancer Infusion Center.  Several things about the Center immediately stood out to me.  First, as I sat in the reception area waiting for my appointment, I noticed that patients exiting from the treatment area most often offered a general greeting to the assembled patients and receptionists – beyond that duly mandated as part of basic Southern manners. Second, there seemed to be a real air serenity in this place where folks came for chemotherapy.  After entering the treatment area on my first visit I heard the staff singing Happy Birthday to a patient hooked up for their chemo treatment.  But what stands out to me most in my last 10 months of Infusion Center visits is the friendliness, care, and concern consistently demonstrated by the staff, particularly the Registered Nurses.

Without exception, the Infusion Center RNs are highly skilled and compassionate individuals.  On my first visit this past September, as a newly diagnosed stage 4 cancer patient, I was confused, had many questions, and really did not know what to expect.  Erin was assigned my case for that visit.  She picked up on my confusion and anxiety and expertly responded and directed me on my questions and concerns.  Whereas the Infusion Center is a busy work environment, there is always room for small talk and personal updates.  For example, Erin and I share a common interest in Latin America.  We discussed my work in the north central Andes of Peru.  She has a brother and sister who are spending part of their lives doing educational and social development in rural Chile and Peru.  This past January she traveled to Chile for a visit.  I was not surprised that Erin and her siblings all are engaged in careers in service to others.

I recently came to know another group of RNs at Touro in the Cardiac Rehab Fitness Center. Following my recent heart attack, I am now scheduled for three sessions per week.  Center patients range from those who appear in pretty good shape to those on walkers with oxygen supplies for whom every physical movement is an effort.  The five RNs who run the Cardiac Rehab Center are experts in their field and incredibly supportive and engaging with all the patients.  As in the Infusion Center, when checking in, taking vitals, and filling out paperwork, the banter among the patients and staff is abundant and contagious.

In addition to the Infusion and Cardiac Centers, I have been treated by about 15 other RNs and dietitians at Touro in the past year.  Without diminishing the role of Touro’s many other technicians, anesthesiologists, and doctors from whom I have also received treatment, my most memorable experiences are with the RN staff.

Nurses often appear considered in secondary roles and not thanked as they should by their patients. Typically, medical conversations skip straight to the doctors.  Now I make a special effort to scan their name badges to remember their names as they remember mine, an express a strong attitude of gratitude for their care.  The only other person I remember talking to me about hospital nurses they encountered was my maternal grandmother.  But then too, as a youth of 5 or 6, my Grandmother introduced me to the bus driver who took us downtown for my annual birthday lunch, and the elevator operator in the garment factory where she worked.  Another lesson learned from my Grandma Kurtz!

So, the point of all of this is to express my gratitude to the exceptional nursing staff at Touro Infirmary, New Orleans, and to encourage readers to make an extra effort to thank those who provide them with care.

Another Day, Another Procedure

Today, in a couple of hours, I will have a laparoscopic procedure and biopsy to try and determine the primary source of the cancer that has metastasized throughout my bones.  The procedure was supposed to happen two months ago, but I had a heart attack during that pre-op testing.

I am less than pleased about the need for another surgery.  I reflected on my contradictory reactions to the different medical procedures I have undergone over the past year.  I thoroughly enjoy going to my cardiac rehab sessions, now three days per week.  When I was having physical rehabilitation last year, I enthusiastically attended those sessions.  The dietitians at Touro Infirmary provide recommendations that improve my quality of life, immensely.  The monthly blood test and x-geva injection that stabilize bone loss are a highlight of my medical treatment.

On a mental and spiritual level, I know that my weekly meetings of the School for Contemplative Living, Enneagram Study, attendance at Rayne Memorial, and other small groups play a big part in my well-being.  Along with bike riding, gardening, and a relaxed professional role, I feel relatively normal.  My biggest physical symptoms are fatigue and controllable stomach issues.

Beyond the two-week recovery interruption to my regular schedule today’s surgery will cause, I know part of my negative reaction is a certain denial that I have a serious disease/medical condition.  I am inclined to leave well enough alone – no news is good news – why do I need to know the primary source of my cancer if everything is rolling along better than my oncologist’s best expectations?

The best place I am at today is just trusting the process, in the same way I have trusted the process in my recovery from alcoholism for the past three decades.  I know that just working the first three steps and never moving onto the introspection of the fourth step would not have allowed me long-term sobriety.  The ignorance is bliss approach does not work.  So, in a couple of hours I will once again be sedated, opened up, and explored.

When I think back to my prognosis last August, I was supposed to be either dead or in the final stages of cancer by last Christmas.  Neither of those events came to pass.

In a couple of days, and maybe even by tomorrow morning, I will be sitting on the back porch looking out on my earthly kingdom.  In a few days after that, I hope to weed and water my gardens again.

I am grateful and blessed in my life today.