Health Update and Birthday Surprises: Embracing Life’s Twists

On my birthday, a very close friend gave me an incredible surprise: a personalized poem written by Jacqueline Suskin, which he arranged through Jacqueline’s Substack. He shared some thoughts about me with her, and she turned them into poetry. You can also experience the joy of receiving a custom poem from her!

Jacqueline Suskin personalized poem

Receiving such a poignant piece of writing during this highly uncertain period held immense significance for me. The messages I received from many of you across different channels after my last post discussing the CT scan report indicating a potential new liver tumor deeply touched me. I'm back on this platform so promptly to share the latest twist in this unpredictable journey in order to ensure that no one worries for even a single extra minute!

Amidst the uncertainties about my health, last week's birthday took an unexpected turn—I found myself in the doctor's office, where I actually ended up receiving the best gift anyone in my situation could ask for. Who knew that even the most advanced CT scan reports from esteemed cancer institutions sometimes miss the mark? The tumor growth initially identified by the radiation oncologist turned out to be inflammation resulting from my July radiation treatment. I'll choose inflammation over tumor growth any day! My body never fails to surprise me, and now, it's added a new lesson to my medical vocabulary—'Radiation-induced liver injury' (RILI). Who would have thought my liver had such an unexpected birthday surprise in store for me?

A Memorial Sloan Kettering birthday surprise

Of course none of this changes the other established facts—I still contend with a partial blockage in my portal vein, while the middle and left hepatic veins remain entirely blocked, and I continue to contend with stage 4 bile duct cancer with a liver tumor and affected lymph nodes. However, that's more or less the reality I've been facing for over two years, and yet, here I am! I credit my continued presence in large part to the conventional treatments that have proven effective for me (including chemo/radiation/targeted treatment, for more info see here).

The ability to continue with my current treatment is a monumental victory for various reasons. The scarcity of effective treatments for my cancer means that utilizing any one of them has the paradoxical effect of getting you closer to a place where treatment options no longer exist. While the goal remains to postpone that day, my priority lies in preserving the quality of life I cherish, making the choice of treatments crucial.

Following last week's CT report, I prepared to explore a new treatment, specifically a clinical trial at a cancer center situated nine hours away, considered the best and nearest option. However, participation in this trial would have necessitated substantial commitments of time, travel, and energy, encroaching upon my limited time here—with no assured success. Considering these factors, continuing with my current treatment brings an immense sense of relief.

And so, after canceling our Thanksgiving plans in California and having a whirlwind of a week, these past few days in NYC with Adrian (who traveled back here with me) and our cherished circle have been a refreshing reset. As so often happens, the unexpected turns out to hold the most rewarding experiences. Instead of facing a new medical team, we delved into the Judy Chicago exhibit at the New Museum (superb!). Rather than sorting out new prescriptions, we set up the Christmas tree, menorah and altar. Instead of medical procedures, we immersed in two captivating films (Miyazaki’s latest, "The Boy and the Heron," and Alexander Payne’s newest, "The Holdovers" – both highly recommended!). And Gutenberg: The Musical had us giggling nonstop. Instead of hospital visits, we explored vintage stores that skip Black Friday and visited our favorite neighborhoods and restaurants. Instead of doubling down with my death doula, we enjoyed a beautiful (albeit chilly!) afternoon tour at Green-Wood Cemetery in Brooklyn, and attempted (unsuccessfully) to continue our tradition of distributing Thanksgiving meals to homebound New Yorkers. Despite our promptness, all the meals had already been distributed—a heartwarming testament to the generosity of New Yorkers! (On a side note for fellow New Yorkers: New York Cares offers a myriad of incredible volunteer opportunities across all five boroughs every day of the week. Adrian and I have been engaged in projects there for years, each one leaving us with cherished memories.)

The past week has reaffirmed several crucial lessons for me, with the most prominent being the importance of embracing change as life's constant companion. It entails adapting to all circumstances without tethering expectations to any specific outcome. It's a reminder that appearances can deceive, and as humans, we operate within margins of error. Embracing a 'beginner's mind,' remaining open to new perspectives and experiences, has proven invaluable in navigating these lessons. Moreover, it was a vital reminder not to solely dwell on the pain of life's challenges, as amidst them, there might be delicate flowers gently drifting down at one's feet—a luxurious carpet adorned with vibrancy and a sweet aroma.

favorite diner

This situation evokes the Taoist parable of 'who knows what is bad and what is good.' In our lives, we frequently categorize experiences as either good or bad, often based on personal preferences. Yet, Taoist teachings encourage us to transcend these immediate judgments, to seek deeper understanding. This parable illustrates the concept that without a definitive conclusion (even in death, the ripple effects persist), we cannot decisively label something as entirely good or bad. Life is an ongoing, unfolding journey. Embracing equanimity enables us to discover peace and acceptance amid life's diverse facets, cultivating harmony irrespective of circumstances.

Here is the Old Farmer’s Parable:   

When an old farmer’s stallion won a prize at a country show, his neighbor called round to congratulate him, but the old farmer said, “Who knows what is good and what is bad?”

The next day some thieves came and stole the valuable animal. When the neighbor came to commiserate with him, the old man replied, “Who knows what is good and what is bad?”

A few days later the spirited stallion escaped from the thieves and joined a herd of wild mares, leading them back to the farm. The neighbor called in to share the farmer’s joy, but the farmer responded, “Who knows what is good and what is bad?”

The following day, while trying to break in one of the mares, the farmer’s son got thrown and fractured his leg. The neighbor called to share the farmer’s sorrow, but the old man’s attitude remained the same as before.

The following week the army passed by, forcibly conscripting soldiers for the war, but they did not take the farmer’s son because he couldn’t walk. And the neighbor thought to himself, “Who knows what is good and what is bad?” realizing that the old farmer must be a Taoist sage.

Wishing everyone a safe and joyous continuation of their weekend filled with warmth, laughter, and cherished moments.

And just in case anyone's feeling particularly writerly this weekend and pondering what to scribble in their journal, here are a few prompts for your profound reflections!

1. Have you experienced a situation where what initially seemed unfortunate turned into an unexpected blessing or opportunity?

2. How do you navigate uncertainty and unexpected changes in your life, finding balance in challenging situations?

3. What practices or perspectives help you maintain equanimity and adaptability when faced with unpredictable circumstances?

Green-Wood, Brooklyn