Dying? Dying.

I generally pride myself with not saying stupid things. I will write stupid things
and think stupid things, but I try not to say them. Nevertheless, if the synapses inside
my head have not said hello to each other by now, there's little, other than a shovel-ready
program of Nembutal, that's going to help. 1
Then again, if your synapses are
undeveloped or burnt out2, Thorazine is always a nice anti-psychotic.3 4
The brain is a complex organ. Not as complex as the mouth, of course, but I'll
tell you about that later. When I was a teenager, I had a teenage brain, or so the
anatomists in the crowd claimed. My parents begged to differ, sometimes strenuously,
maintaining that there was at least at that point no physical manifestation of any
brain, much less brain activity. At least normal brain activity.
If you want to be a little depressed, how about this: Neurologists say that the
prefrontal cortex is the part of the brain responsible for wisdom. Not only wisdom, but
complex planning and decision making, moderating social behavior, and understanding
pre-decision to act, the ultimate consequences of one's planned choices. If you have
teenage boys, that says a lot.
Anyway, stupid stuff still flows, under the guidance of a -working-part-time
prefrontal cortex, from my mouth. One of the dumbest things I've said - or rather asked
occurred shortly after I was diagnosed with a recurrence of my throat cancer.
When I was diagnosed with the recurrence, no professional medical types needed
to tell me that I was in trouble . . . again. I could see the ultrasound image and I could
see the look on the technician's face. Those ounces of information were worth a few
pounds of lab tests. You know those TV images when a hurricane or tornado is in the
neighborhood? The weatherperson stands in front of a green screen and points out areas
of green, red, yellow and orange. Then he or she tells you that if your house or mobile
home is in the middle of the orange center of the frenzy, the you should get the fuck out
of Arkansas, or Oklahoma5, or wherever the storm might be.
That's exactly what my scan looked like . . . the orange center of a vicious hurricane
1 And Nembutal is sometimes administered for confusion and hallucinations. The manufacturer lists
confusion and hallucinations as a prominent side effects of the drug. Does Henny Youngman write their
labels?
2 Or both.
3 Psychosis is defined as a loss of contact with reality. This may be out of Henny's league. It may
take Mitch Hedburg to not explain this one.
4 Thorazine's still in use sixty years after its invention. It was invented (discovered?) by the French, so
they obviously did better with that than with the Maginot Line. And if Nembutal and Thorazine don't do
the trick, there are older much older remedies. You can go to the Whitehorse Tavern in Newport,
Rhode Island, which claims to have been established in the 1670s, so you can bet that a lot of therapy has
been rendered there.
5 I don't want to give anyone a bad name, but if you live in Arkansas or Oklahoma or Missouri or
Alabama - you know it's true. The weather screens are up and projected 24/7 and the weatherman just
changes his jackeyt to pretend that it's different storm.

surrounded by irregular rings of yellow and red. And the tech just ran his little hand-held
transducer back and forth, forth and back, over the same spot on my neck and in the
darkened exam room, the center of the storm was right here my original lymphatic tumor
had been: directly under my jawbone. And the tech's face belied all intrigue or doubt.
He looked like he'd just come out of a final exam on the Platonic Realm after having
studied Mendel's Peas by mistake. When he finally put down his tool, he said, Uh, uh,
uh . . . could you give me a minute? I'll be right back.. Twenty minutes later he
showed up. That was too many uhs for me and nineteen minutes too long an absence.
Anyway, much flurry and drang followed, during which time I learned that none
of the three of my top docs was available for a consult with me. One was in Hong Kong
giving a speech about how fucked I was; another was in surgery which would likely take
another six hours; the third had taken the day off. So, I had the good fortune to be
escorted to Dr. Sturgis' physician's assistant, Jennifer A., who re-confirmed the findings
of thirty other pathologists that morning and set about typing at her laptop in the exam
room. This is the point at which I was sure that the cancer had attacked my prefrontal
cortex.
Am I going to die? I asked.
There was an eternal pause in her typing and with her back to me she turned a
quarter of a turn on a swivel stool, dropped her head with a mildly condescending stare,
looked at me over her shoulder, and replied, Yes. Whereupon she turned her back on
me again and resumed her typing. I laughed. Loud and hard. Treating docs don't give
you a decent prognosis anyway, and Jennifer's answer was spot on not to the world's
dumbest question, but one which ranks in the top twenty or so, surely. Indeed, I am
going to die. That was true then in August of 2014 and it still is.
When I was born, in the first few minutes of having emerged into the raw glare
of a sterile, phosphorescent-lit room, after assessing the permanence of my new
environment, I reckoned.I wonder how long this new state is gong to go on. The
answer, in 1946, would have been 65 years on average.
You certainly don't contemplate life expectancy when are absorbed with the
prospects of girls and alcohol or pot, at fifteen or sixteen . . . or today maybe eleven or
twelve. Much less, upon graduating from college and contemplating surfing, bartending or dog walking as viable careers. But life expectancy becomes a very tangible
concept upon one's second cancer diagnosis, this one coming after in June 2014,
according to the doctor's clinical notes - the patient is in clinical; remission. Ha! One
oncologist friend, in response to a papal bull that I sent her on my predicament, wrote
me back to me in toto, You have a particularly stubborn cancer. I just wrote back,
Duh.6
___________________________
Jennifer would have been right regardless of the person to whom she was
6 Unbelievably enough, she is still speaking to me, which is evidence of either her profound sense of
self-esteem or her grossly misplaced tolerance for a miserable soul.

deadpanning. You, dear reader, are going to die. And I hope you are blessed by a quick,
if not early, demise. My friend Dick L's parents both died in the same year and both
passed quick, each of a heart attack. His father was found dead on his sailboat, where
he went to unwind.7 And his mother also died of a quick heart attack shortly thereafter. 8
Compare them to those who linger on the threshold of death for years . . . decades . . .
centuries.9
I've said before that people tend to underestimate the good things that lifethreatening cancer can bring. One of my best experiences during cancerdom, was
reading my oncologist's the clinical notes. After two paragraphs, short ones at least, he
waxes eloquent:
After a sequential treatment program with induction
chemotherapy then chemoradiation for squamous cell
carcinoma of the left tonsil, T2 N2b M0, Mr. Terry
returns for multi specialty evaluation. He reports feeling
much better. There has been healing after he developed
severe treatment effect mucositis. He required G-tube
feedings. A CT head and neck scan shows evidence for
a left upper neck tumor recurrence,10 with the left
oropharynx mucosa clear, but development of nodal
involvement. This has prompted an ultrasound
examination revealing a 2 cm11 left upper neck mass,
with cytology showing invasive squamous cell
carcinoma.12
As indicated, a systems review shows no new
subjective problem. Mr. Terry is up and ambulating,
starting to take oral feedings more regularly, and he
generally feels physically well. Repeated physical
examinations show a bright, alert patient, afebrile, with
vital signs stable. Mentation is intact. Affect is
appropriate. There is an ill-defined left upper neck
fullness consistent with the imaging findings. The
7 Thomas Hardy and Henry James , even O'Henry, wold grin.
8 She died, Dick explained, of a massive heart attack. Why do people have to add massive to
descriptive a fatal heart attack. Isn't A heart attack killed her instantly, massive enough? It is for
me.
9 In the case of Methusala, that is, who lived to be 969 years old and for whom the last 889 years he was
bedridden, and without the Affordable Care Act yet in place.
10 Head and neck scan shows evidence for a left upper neck tumor recurrence
is doctor-speak for It's baaaaack.
11 A little less than three quarters of an inch.
12 How the hell does someone develop a nearly one-inch tumor in sixty days after being diagnosed as
cancer free. Particularly stubborn, is right!

remaining
physical
findings
are
stable.
13
Mr. Terry is a candidate for neck dissection. We are to
be conferring with Dr. Sturgis. Treatment goals remain
curative for this man.14
So, when is the last time that someone told you that you were afebrile? You
have to admit that doesn't happen every day. And how about Mentation is
intact. My friends will be shocked to read that, mostly because none of
them know what mentation means . . . and neither did I until I just looked
it up. Bright and alert? It's almost worth the cancer to get such positive
feedback. Feedback that's even less stilted than my first performance
evaluation after graduate school.15
When you are close to death people write all wonderful, glowing and
positive, of course things about you. When you get cured, the fan base
rapidly scurries off to support a peer who is worse off than you are. But you
can still savor, albeit in relative quiet, that you have intact mentation and that
you're afebrile.

13 A damned good candidate as things turned out.

14 See the title of this book.
15 I got all 10s. On a ten-point scale, that is.