Tuesday, December 13, 2023, 11:00 AM: On this day, I learned something from an endoscopy performed to look at the tumour in my throat.
My wife and I were with an oncologist in a Cancer Centre exam room. He picked up a thin cable tipped with a tiny video camera and a light-emitting diode. The other end of the cable was connected to a large monitor.
The doctor inserted it into my right nostril, threaded it through my nose, and into my sinus cavities. He pressed it until the camera exited from my sinuses far into the back and top of my mouth.
The camera and light were now pointing down my throat. On the video monitor, however, it looked like we were seeing into a strange pinkish cave, where the healthy flesh looked like weird, wet stalactite rock formations. The root of my tongue looked like the cave floor, and the opening of my throat was a door into the back wall.
And there, at the juncture between the floor and the wall, was my tumour.
Inserting the cable wasn’t easy; some patients must be sedated. Why were we doing this?
Because the tumour survived the last round of chemo at the end of August, we’re starting a new series of chemotherapy infusions. Today, we looked at the tumour to set a benchmark: We’ll look again in a few weeks to determine whether the chemotherapy has helped. Our consistent experience is that our subjective reactions to looking at the tumour predict the future better than the diameter measured by CT scan.
Friends, the tumour was hideous. The bulge had grown substantially since the end of my last chemotherapy cycle. Its mass presses on my epiglottis, the flap of tissue in your throat that closes so that you can swallow food and liquid without getting any in your lungs. The tumour’s impingement interferes with the functioning of my epiglottis, making me cough and choke frequently during meals. Preventing this to protect my lungs from infection is itself a major life project.
The contact between the tumour and epiglottis also explains why my tumour is inoperable. A surgeon could cut it out, but not without severely damaging the epiglottis. Then I would experience frequent lung infections—that is, pneumonia—one of which would likely kill me.
The ulcer on the top of the bulge had also increased; it bled copiously a couple of weeks ago. There are new patches of redness, like abrasions; perhaps the tumour will soon break through there. Large masses of purplish green necrotic tissue surround the tumour; it’s the flesh of my throat, killed by the tumour.
Nevertheless, the tumour won’t kill me soon. I am still functioning well. It’s my third cancer relapse in just four years. We’ve had to restart chemotherapy sooner than we had expected. The chemotherapy will shrink the tumour—we hope—but it survived the same drugs last time so they won’t kill it now. But we can likely knock it back some and get more time.
The insertion wasn’t painful per se, but the pressure of the cable passing through the interior of your skull FELT SCARY WRONG. Nothing foreign was supposed to be there. I had to suppress the urge to grab and pull the cable out.
Of course, I tried to relax. But trying hard to relax feels like clenching.
But something happened to me while the doctor was inserting the tube. Something in me surrendered to the cable, even welcomed it. There was a complete release of tension, a kind of bliss. I didn’t will my surrender; it happened to me.
Surrendering was waking up: I suddenly experienced not just the material presence of the cable but also its intention and meaning. The insertion was an act of care, and care from a physician I trust is a disciplined act of love.
In that state of mind, I turned toward the video monitor and looked at the tumour. Yes, it was hideous, a tocsin of death. But the surrender overpowered it, extending to become a surrender to my illness and, beyond that, my death. That death will happen, and I will do my best to delay it. But dying doesn’t matter; it’s how I use the gift of life.
Despite this hideous, painful, lethal growth, it’s a beautiful life, an evening under low clouds.
"But dying doesn’t matter; it’s how I use the gift of life." I'm sorry this is happening and am grateful that you continue to share your wisdom with us.
Clicking “like” seems wrong, but as ever you write so beautifully. I’m hoping this round of chemo buys you time, brings relief from the pain and discomfort, and will allow you and Kathy to enjoy the holidays and beyond, surrounded by family and loved ones. Pam and I send our best wishes.