(written after hearing this haunting sitar piece by Anoushka Shankar)

Mr. President, we share your grief, both for the individuals affected by this horrible tragedy and for Israel. However, we cannot offer one-sided comfort.

Israel has turned a blind eye to the abuses of settlers, religious zealots and the IDF. You omit even the merest mention of the Palestinian suffering they have caused. When you do this, you elevate your suffering and dismiss theirs.

Mr. President, Peace is the only way to stop this suffering. And Peace will only come when you see the humanity of Palestinians, and they see yours.

Mr. President, you must see their humanity. You must grieve with Palestinians as you are grieving with Israelis. You must kiss their cheeks and taste the saltiness of their tears. You cannot have Peace if you cannot do this.

Palestinian extremists in Gaza and elsewhere cannot see the humanity of Jewish people. They only harbour hate, only want bloody revenge. And the Jewish extremists in Israel cannot see the humanity of Palestinians. They cannot conceive of any peace with them.

Let the rage boil over and the sorrow be spent. And then, go grieve with Palestinians who want Peace as much as you do.

I’ve never been happy with the search for extra-terrestrial life. All the popular depictions of extra-terrestrial aliens — little green men with huge eyes or tentacled giants that whisper an incomprehensible language — are projections from insecure minds. In the 1960’s, when NASA was developing life detection devices for its planned exploration of Mars, scientists were proposing contraptions that reflected their biases. As James Lovelock remarked, microbiologists were looking for microbes, parasitologists were looking for parasites, and so on. To circumvent these biases, Dr. Lovelock went about it from first principles: life, if it exists, will shift the chemical equilibrium between the atmosphere and the planet’s surface. He argued that we should look for this kind of signature as evidence for the existence of life. He went on to demonstrate that this wasn’t the case for Mars.

Still, the argument persists and we continue to spend a great deal of effort hunting for exoplanets or listening to the skies. The argument is not about intelligent life or parasites, but about the odds. It is argued that there is a fixed chance that life appeared on earth, say a one in a quadrillion chance, and it is argued that there are probably more than a quadrillion exoplanets (whatever the correct estimate may be), therefore life is likely to exist on exoplanets. There’s an irresistible belief that there must be life elsewhere and that we are not alone in the universe.

Are we truly unique? Could there be human-like life elsewhere?
What does life look like elsewhere?

Terrestrial life is uniquely the result of evolution on this planet. It has been shaped by solar fluxes, surface temperatures that keep water liquid, tectonic forces that keep land masses ever changing, the composition of land, water and the atmosphere, seasonal climates caused by the tilt of the earth, tidal influence from the moon, etc. The arrival of humans was not inevitable, but it required all the previous steps in the evolution of living organisms and the environment in which we appeared and thrived. We could not export humans to Mars because the entire evolutionary history that makes us fit for Earth is lacking on Mars.

If life exists elsewhere, it will also be uniquely shaped by the solar and planetary influences of that planet. It will be spawned from the energy that interacts with its surface, a part of which will be captured and directed towards ordering matter, like we do. Whatever forms it evolves into — if it persists — will follow the unique trajectory set by planetary forces, just like our own journey.

Unless the earth has a celestial doppelgänger elsewhere in the universe, I argue that humans exists only on Earth and nowhere else, that we are uniquely the product of terrestrial evolution, and that life elsewhere will be uniquely the product of its exoplanetary evolution.

There may be life beyond the Earth, but humans are earth-bound and we alone.

I saw the storks, dry grass and olive groves
Driving through villages in old Algarve
I saw its history stained in people’s clothes

I smelled the air, the flowers and the cloves
Watched happy children swimming with no clothes
I saw the storks, dry grass and olive groves

I heard past wars, hard battles and cooing doves
I walked the pavements of blood and sweat and stones
I saw its history stained in people’s clothes

I watched bright boats moored close by where I drove
Walked by old churches and ghosts of ancient Moors
I saw the storks, dry grass and olive groves

I heard great songs, of joys and deepest sorrows
Drank in dark taverns, with marks from friends and foes
I saw its history stained in people’s clothes

I felt their hearts, fierce pride and gentle souls
I felt great warmth through villages where I drove
I saw the storks, dry grass and olive groves
I saw its history stained in people’s clothes

*I recently returned from a two-week trip to Portugal and put my impressions in this poem, written as a Villanelle

Mine was an unhappy upbringing. There were good moments, but they are obscured by the sheer terror of being chased by my mom, furiously waving a thick wooden spoon to strike me. I developed my creativity by finding the best hiding places, like the tiny space on top of the fridge where she couldn’t find me. There, I’d wait out her fury, safe for the moment.

My brother was her independent associate, telling me at every opportunity what was wrong with me. I hated him as much as I idolized him for being everything I was not. Needless to say, this cultivated in me a complete lack of confidence.

School was a balm for me. When I entered primary school, it was still run by the Catholic Church in Québec. The nun who taught me grades 1–3, Soeur Marie-Léo, showered me with love. In retrospect, I’m sure that she didn’t specifically love me, but her warm smile and kind demeanor made me feel that way. It was the peace that didn’t exist at home, a peace my 6 year old mind could only intuit.

We didn’t study the bible, but learned from Catechism, which I memorized from cover to cover. The stories were OK, but it was its deep sense of morality that left an impression on me. To my impressionable mind, Jesus didn’t pick sides: he’d stand by whoever was treated unfairly. I could relate.

Other aspects of the religion were far less appealing. We’d go regularly to mass on Sunday morning and recited by rote the entire ritual. It became a meaningless exercise. I’d fight my fidgety boredom on the pews by unstapling the pages of the week’s hymn book, shuffling the pages, then carefully restapling them together, beginning with page 7, then page 11, then back to page 3. I anticipated with pleasure the confusion of the parishioner who would pick it up at the next service.

A day earlier, I had gone to confess my sins, making up some believable middle-of-the-road sins that wouldn’t carry too high a burden for repentance, typically a couple of Hail Mary’s and three Stations of the Cross. This fakery didn’t bother us too much because we believed the rumour that the parish priest would get drunk after mass. Week-in, week-out, we’d repeat the same empty rituals, as though this absurdity needed practicing.

I discarded quickly the empty shell of Catholicism, but remained with a nagging feeling that there were some deep truths in what I was taught. I felt that I hadn’t come close to understanding these truths. Later, my friends turned to other religions and spiritual practices in search of guidance for their lives, but I rejected that notion. How could we find the right way to live from ideas and practices developed in a different context by totally different people?

At university, I studied Biology, but read philosophy on the side. Even though philosophy seemed like a relevant pursuit, it felt like an attempt to codify what I had learned earlier, to provide a rational basis for something like goodness or justice that was fundamentally irrational. The best reading I found was from another source: A Theology of Liberation. It argued that Catholicism was the present pursuit of respect and dignity. Not in some distant afterlife, but here and now. This spoke to me.

I started revisiting what I had been taught earlier. This version of Catholicism wasn’t the empty shell I grew up with. It was justice as a concrete, daily practice. It demanded that I live my life according to my beliefs, that I engage with the world according to my beliefs. In that light, Jesus was not some Godly figure to adore, but an everyday rebel in an unjust world.

I re-examined confession. I didn’t want this to be some theoretical notion like I had practiced, but a practice that is informed by my own experience. And then, I recalled the deep relief I felt when I admitted to a wrong I had done, shedding the burden of guilt I carried. Shedding the continued effort to conceal the truth that I could do bad things. Confession was a way to cleanse myself, but, done properly, it could only come when I recognized the harm I had done, when I could feel within me the hurt I had caused to another person. Then, I felt compelled to admit to that wrong and seek forgiveness, to atone for it. In this way, confession wasn’t only about relieving myself of guilt, but it was about righting a wrong and mending a broken relationship.

Another profound experience made me question what I had learned about God. While doing my PhD in 1983, our newly-elected government introduced a regressive agenda under the guise of fiscal austerity. There was an immediate, province-wide reaction to this and I was swept up in the protests. I was appalled that they eliminated Human Rights tribunals, since these bodies were formed to streamline the process of adjudicating complaints and save money. These and other measures were vigorously opposed, but only limited concessions were made in the end. Unhappy with this outcome, I decided to fast in protest.

My original intent was to fast until Human Rights tribunals were restored, but I decided this wasn’t right. It felt fundamentally unfair to make the burden of a political decision contingent on my life. Besides, there would be other battles to fight if I lost this one. Instead, I decided to fast for 40 days.

I questioned my motives before arriving at that decision because I knew that I would falter if I proceeded for the wrong reasons. Was I trying to impress my friends? Was I trying to prove myself, deep down, before my brother’s judging eyes? The questions were painful for the honesty they demanded. It is at that time that I felt the presence of God.

One night, when I felt unable to arrive at a clear answer, I began to pray. It was not one of those canned prayers I had learned, but an earnest call for help, for finding strength when I was unable to find my way. I felt God’s presence in my weakest moment, an unmistakable sense of God being present, embracing me. God was neither a man nor a woman, but a strengthening presence that lifted me and brought clarity and determination. With that clarity, I went on to fast for 40 days, finding it less difficult than the reflections that brought me to this decision.

Unlike the God I hear about from preachers, this God I felt was not material or a person, but a strong presence that I felt at my greatest moment of weakness and humility. It is almost the opposite of what I heard growing up, or hear from every preachers.

As I lived my life and confronted my shortcomings, I revisited the concept of original sin and of redemption in the afterlife. I came to realize that everything I learned about it is wrong. Hell is not some faraway place where we are cast after a final judgement, but the very condition of an unhappy existence. Our shortcomings, whether from birth or acquired in our formative years, are what keeps us in this place. These are the sins that Catholics talk about. We can deal with them by shutting them inside some unreachable internal compartment or we can confront them to better ourselves.

That last option is appealing on paper, but it is not for the faint of heart. It requires enormous courage to root out the ugliness we carry inside, sometimes unseen, yet it is the only way to cleanse ourselves of it. It is a lifelong process.

I came to conclude that I will not miraculously fall upon a paradise once I root out all these blemishes. That idea demands that we put our lives in abeyance and live miserably until everything is fixed. I reject this idea. Instead, I chose to accept that I am not perfect, that I must work to rid myself of my imperfections, but that I can still enjoy life despite being imperfect. Self-acceptance, Catholic or otherwise, is your ticket to earthly paradise.

Along with this comes forgiveness. Forgive myself for being imperfect, and still carry on. Love myself because to love myself is to forgive myself for all my imperfections. Seeing imperfections in others and forgiving them for the same reason. Finding it within me to forgive my mother, a victim of the Holocaust, which was one of the hardest thing I’ve ever had to do. Unexpectedly, this brought me inner peace.

With that understanding of forgiveness came the final lesson I learned from Catholicism: the concept of Grace. Living with Grace means to me that I can see and feel the imperfection of my life, see and feel the imperfection in others, yet I proceed onward in this imperfect world, confront its ugliness, rather than keep myself in the safety and comfort of a world I create for myself. Grace, like foregiveness, demands courage and humility.

I tried to live my life according to the principles I believe and I largely succeeded. I look back and feel good about it, having shed most of the unnecessary baggage I was carrying. Now in mid-60’s, I look at Catholicism — or any other religion — and feel that I do not need to listen to them unquestionably. I keep their good and discard their bad or their useless. The sacred texts remain authoritative sources, but the experience of my life, a life tried and tested, fully engaged, has granted me an authority that makes their religious decrees unnecessary. I know that I am not perfect, but I accept it, as I accept it in everyone else. In the end, it’s still a pretty good life.

If my apartment is my country

Then my bedroom is its capital.

And in my bed, it’s parliament,

I confer with all the wise men

About the problems of my soul.

We discuss and debate,

Dream and panic,

Get up drenched in sweat,

Or lay motionless, wide awake.

Occasionally, we wake up in the middle of the night,

The answer finally at hand

And then, triumphant, we return to peaceful sleep.

As always, there will be new deliberations tomorrow.

When I lay by your side

Quiet, filled with love

Every breath is a poem

Its own moment of beauty

There are plenty of reasons for despairing. Ukraine is being invaded at the moment, the latest salvo from autocrats who want to squelch our democratic impulses. It was Hong Kong before. Can Taiwan be next? The most recent IPCC report paints a dire picture of our deteriorating climate, and biodiversity continues to be diminished around the globe. And, of course, there’s the unending Covid pandemic …

Still I remain optimistic. It isn’t an ebullient optimism, and I definitely feel challenged, but my own experience has taught me that no matter how deep we sink, we always get back to the surface.

It helps to have some perspective. My dad fought in World War II and he described to me several harrowing moments. How the rucksack full of hand grenades miraculously did not blow up when he threw himself to the ground, escaping enemy fire. How he swooped up from behind his barricade at exactly the same time as the German soldier across the street, 30 feet away, gun barrels aimed squarely at each other’s faces. What saved him, and the German soldier, was their recognition that they were only teenagers, more alike than different, causing them to pull back without firing the deadly shot. How he survived hard labour camp, with meagre rations and hard work, sleeping in rags on the frozen barrack dirt floor, only to start again the next day.

There were plenty of reasons for him to give up, but he didn’t. Had he done so, I wouldn’t be here writing this essay. But he is still here and I am alive, and I owe it to my children to keep persevering, just as he did for me. This is the fundamental imperative of Biology: I must do what it takes to survive, by wit and skills, so that my children can prosper in the world.

My life experiences have shaped this positive disposition. Primary among these are experiences from a life of engagement.

As a student, I didn’t just read books and theorized: I was an active environmentalist and scientist. I organized opposition to destructive industrial developments. I organized lectures and symposia, participated in various actions. I helped create a student organization examining the ethical responsibilities of scientists.

This engagement countered the helplessness that prevailed at the time. It gave me a sense that solutions can be found and worked towards.

After graduation, I committed to use my scientific training to make a positive contribution. Many problems existed at the time — racism, environmental degradation, misogyny and inequality — but I chose to focus on only one : the detoxification of contaminated waters at mine sites. This reflected a fundamental choice: rather than solving all the problems by myself, I chose to work on one and do it well. Besides, it matched my knowledge and skill in biology and chemistry. Though I might be sympathetic to many issues, I resigned myself to working on only one problem, counting on other people to address the others. Is this naïve? Perhaps, but my focus allowed me to become effective at my work, while keeping out guilt about things I couldn’t help effectively.

I started my environmental consultancy in 1989, designing natural systems that cleanse polluted waters. At the time, the mining industry was dubious about environmental problems and resisted addressing them. They seemed like irritants that only represented an expense. However, I began to develop natural treatment systems, and my work proved that they provided both practical and economic solutions. Slowly, the attitudes of industry changed (I wrote about this here).

My ability to solve environmental problems grew with increasing experience: I could offer solutions that were acceptable because they were practical and economic. It has taken more than 25 years, but I am now seeing the payoff to my long-standing commitment to environmental protection.

The change I have witnessed in the mining industry took place gradually, from dismal beginnings towards the current embrace of environmental and social responsibilities. Similarly, I feel that solutions to our current problems are obscured, but they will eventually be revealed when we commit ourselves to solving them.

Does this mean that I didn’t get down and feel despairing? Of course I did. I nearly went bankrupt in the mid-1990’s and eventually had to close down in 2009 the consultancy I started 20 years earlier. This was a very dark period. Despite these times of desperation, I always buoyed back to the surface and returned to my work. Anyone who tries something difficult will face similar adversity. I found strength from the knowledge that my family also prevailed over their own hardships.

Where will the solutions to the problems of inequity, climate change and biodiversity come from? I don’t know exactly, but I do know that solutions only appear when we engage ourselves with problems and work at them. That’s where diligence, ingenuity and creativity come in, breaking problems down into manageable pieces and solving them one at a time. Though progress is slow, our engagement allows us to see progress and a distant solution where onlookers see none. It counters the helplessness that feeds pessimism.

My optimism is a trust, borne out of my experience, that our ingenuity and perseverance will eventually prevail. Our dedication creates a path towards solutions where none existed before. My parents did it before me, I have done it for my children and they will do it for next generations. It’s the assignment passed on to us by previous generations, an assignment that we must complete.

Every generation faces its own challenges. Arm yourselves with tools to address them, whatever they may be, and commit yourself to resolving them, for the sake of future generations.

With one fingertip,

I will discover you.

Slowly, I will discover your body.

Let my fingertip settle on your head

Then trace the contour of your bare skin

Over your shoulder

Your breast

Your belly

Your hip

Your thigh

Your calf

Your ankle

Glide in-and-out of your toes

Under your arch, ‘round the heel

And then slowly glide up again

To where you are waiting

Now soft with desire.

My fingertip will trace the contours of your beautiful mind.

Slowly,

I want to know all of you

One thought at a time.

One laugh, with twinkling eyes,

One reflection, passed back-and-forth;

And the silence in between

To let it shape itself,

Onto the contours of our minds.

My fingertip will melt into your heart

With each kiss,

With each caress,

A tender invitation

To soften your protective layers,

To accept my love

To open it as its home.

My fingertip will whisper to your soul,

And trace its contours.

It will discover its yearnings

Parcel out a place of calm

Among the swirling currents.

A place to rest and replenish

To set ready and go back again into the world.

It will find the essence of you

Of joy and of hope.

And there I will meet you.

Heart to heart

Soul to soul.

All parts of you I want to discover

Tracing your contours with my fingertip.

In December 2020, my doctor felt that my prostate was enlarged. She sent me to a urologist who confirmed her assessment. A biopsy taken in April 2021, while spring was in full bloom, showed that I have aggressive prostate cancer.

At the time, I was a healthy 64 years old. In the months that followed, I wrote these notes to myself and various friends. They are less technical manual than inner reflections as I navigate through this crisis in my life.

This is how my year unfolded.

Part 1. Before the Surgery

June 3, 2021. Dear Eleanor

It’s hard to think that I am ill when I feel perfectly healthy: I can only understand it intellectually.

Adenocarcinomas are cancers found in mucosas of glandular tissues: prostate, breast, lungs, pancreas primarily. (At my age, it’s from the prostate). They grow rapidly and have a propensity to migrate to other tissues, like liver or spleen or bone marrow, where they would be transformed and spread. (I’m toast if that happens).

That’s my mental picture of this illness.

I spoke to the urologist and he said that we have three months to intervene. That means there’s a risk — a tiny risk — that the cancerous cells have already begun spreading out of the prostate. That risk gradually increases over the next three months. So we have to move swiftly and deliberately. Already, I have been to the hospital to get a bone scan, and I am going tomorrow to get some blood tests. We have scheduled an additional series of diagnostic tests and will reconvene at the end of June, with all this information at hand, to make decisions. If the cancer is confined to the prostate, then he recommends to excise it and, hopefully, that’ll be the end of it. There may be consequences, but they don’t compare with cancerous cells spreading to other tissues.

I’m shifting my priorities and directing my energies to my well-being. I don’t care if I upset someone because I did or didn’t apologize properly for something three years ago. Now, I spare my energies, away from these wasteful concerns. Does my son feel fragile from something going on in his life? I can’t be there for you sweetheart: I must look after myself at this moment. I have never acted this way, but everything shifted with the diagnosis.

Another shift. While showering this morning, I noticed how my neck and shoulders are stiff, like they always have been. Does this account for my poor sleep? There’s a good chance it does. I now need my sleep and my full strength. And if I need to pay a massage therapist to loosen up these muscles, then that’s what I’ll do. A week ago, this felt like an unacceptable indulgence. Not anymore. Perhaps it’s a good thing that I shouldn’t try to endure life, but actually make it easier on myself.

June 3, 2021. Eleanor’s response.

June 5, 2021

It’s an odd juxtaposition, the struggle within me. For the past two weeks, I’ve been trying to come to grips with the reality of cancer growing inside me, but that reality is elusive. All my friends are worried for my wellbeing, yet I feel fit and strong. Except I know that it’ll be too late by the time I actually feel unwell: by then, the cancer will have spread through my body and made itself unmovable. I have to proceed while I feel nothing, cut off the bad part while it feels normal. It’s not an enticing prospect.

While all this is going on, I am preparing a conference presentation about research I conducted 20 years ago, work that I was prevented from disclosing. It’s also my highest intellectual achievement: I discovered bacteria that dissolve gold and can be used to extract it instead of cyanide. As a colleague wrote, “a revolutionary new process!” … except the hype is unwarranted because I never fully succeeded. It was very cool work and I am happy to finally reveal it. Maybe someone will carry it forward and become very rich from it. I don’t care: I’m done with that chase. I’ll let the next generation pick up from there. Life goes on despite my inner turmoil.

June 9, 2021

At the beginning, this whole thing felt unreal, or rather, unwarranted. I felt solid, biked regularly to play pickleball, then biked back home after 2–3 hours of play. Everyone was fretting about me, but I couldn’t make sense of it. Palpation showed a slightly enlarged prostate and one side to be a bit harder. Blood tests showed elevated prostate-specific antigen (PSA). It was above baseline, but below the red flag level. I figured: OK, I can manage it. Worse comes to worst, the prostate will be cut out and that’ll be the end of it.

Taking the biopsies rattled me a bit. For one thing, the ultrasound probe guiding the tissue sampler revealed a nodule or lesion on one side of the prostate. The sampling itself wasn’t any more uncomfortable than going to the dentist. Sure, you can feel the drill, but you feel no pain when you’re well frozen. All the apprehension is in your head. However, the following week was unsettling: blood was coming out of my anus (wear maxipads), urine (peeing blood is off-putting), and semen (I had to test it). In a weird way, the blood in the urine worried me less than the blood in the semen. For reasons I can’t explain, blood in the urine is “external”, whereas blood in semen is “internal”, as though I carried a terrible illness that I was terrified to reveal. Maybe I was afraid that my lover would be horrified at me and suspect a contagious malignant growth.

This lasted for 7–10 days, and then I went back to normal. I had a bone scan that showed no sign of malignancy. This brings me to Monday’s meeting with the urologist to discuss treatment options. That’s when it became real.

First, we reviewed the results. Two of the biopsies came back positive: one moderate and one high risk. “Can’t we just take out the visible lesion?”, I asked? Nope, this kind of cancer is usually multi-focal. The whole thing has to go. OK, I thought, what are my options? Take it out surgically or nuke the tar out of it. That seems simple enough. “But there are consequences to either option” said the urologist. Oh.

For my age and physical condition, the chances of full recovery are excellent. The side effects are another issue. Erectile dysfunction. Incontinence. Both could either be short-lived or long-lived. Irradiation can burn some tissues next to the prostate and cause cancer several years down the road. It’s not a big deal when you’re 80, but it is when you’re 64. The lymph nodes above the prostate must also be removed, in case the cancer has already migrated there. Prophylactic surgery, but probably warranted. All it takes is two cells wandering off … and they’re off to invade my body. They may already have migrated into adjacent bones or tissues, but are still undetectable. Who knows?

All of this rattled me. I took it all stoically in the urology office, keeping rational as I kept asking probing questions (“What about if I have to make a trip to a mine site in the High Andes during my period of recovery? Hmm: not advisable”). Otherwise I stayed cool. It felt like I could sail through this. The bad dream that night told me otherwise. There is fear deep inside, but I haven’t allowed it to creep out. I’m sure that my life will change, in ways as yet unpredictable. Maybe the last time I made love was really the last time. Maybe I’ll carry one of those pee bags for a long, long time. Ugh.

And then I started thinking more broadly. What’s dating like when I know that I am mangled? So much of a man’s identity is in his sexuality, his performance. But then, it’s the same for women who have breast cancer and undergo a mastectomy. What could Angelina Jolie have been thinking when she removed both breasts because she carried two cancer markers? Angelina Jolie: this icon of beautiful boobs, voluntarily cutting them off!

In an odd way, this brought me comfort. We both struggle with an invisible foe. She had the courage to do it. I know of other women who survived breast cancer and carried on living a good, long life. I can do this too!

Terry, my doctor of Traditional Chinese Medicine, chastized me for getting sucked into the fear instilled by the urologist. Actually, I don’t care. I will feel everything that I feel, without suppressing it. I will let it wash over me, shake and sweat in my bed. But now I trust myself. I will get through this, just as many men and women before me got through their cancer. We’ll be different on the other side, but we’ll carry on. I will carry on.

June 21, 2021. Letter to Eleanor

A big wave of tears welled up in me tonight. It was overwhelming earlier, far more than I could cope with by myself. I have no one else to speak to, so I turn to you.

Today, my family doctor called to tell me that the CT scan came out clear: no malignant cells had migrated to healthy organs. As with the bone scan before, I entered into it bravely, stoically, even with a dash of humour. But now, I broke down with the news of being clear.

I know that I store my anxiety inside, and these outbursts are the release of pent-up fear and anxiety. But there was something else to them and I finally figured out what it is. Before telling you, I need you to listen to this song. It’s a love song, but with a hint of bitter sweetness. Please listen to it before you read on.

I weep at the longing for love that comes from this song, but I weep at something much deeper as well, something drawn up by the results of the CT scan. I held onto the fear that I might be ravaged by cancer and die quickly. The sorrow that comes is from having done so much good in my life, having it gone unnoticed, and then dying, without having met someone who appreciates me. That’s the longing in that song. It feels like the pattern of my entire life: to have tried hard, to have accomplished, and then to have been ignored.

The deep well of sorrow where this draws from is the little boy, still in me, who succeeds triumphantly and turns to his parents for affirmation, only no one is there. It’s the deep fear of being abandoned. To have lived life but never having found someone who truly appreciated what I gave. It came close with my ex-wife Katie, as well as Annie, a friend, but now Annie thinks I’m a boor.

That fear of dying, of dying in the near future, it’s from having lived unnoticed. It’s a visceral sadness that tears at my insides.

July 4, 2021

Last week, I visited the radiation oncologist. I had already seen the urologist before and heard him describe the merits of surgery. Surgery is decisive, but it also leaves scars. There’s a strong likelihood that I’d become incontinent, temporarily or permanently, and that I’d lose permanently the ability to have erections. Against these known consequences, I was hoping the oncologist would hand me a get-out-of-jail-free card. It didn’t happen.

The cancer diagnostic takes account of all the available information and assigns a score: the Gleason score. In my case, I learned that my cancer is severe, but not yet lethal. It means that eradication must be done promptly and that there’s a significant risk that malignant cells have migrated to other tissues. Consequently, radiation treatment is very potent, involving several interrelated treatments:

· A two-year treatment of hormone therapy (testosterone suppression)
· Radiation therapy using beams external to the body, to destroy cells in lymph nodes and other tissues surrounding the prostate
· Internal radiation, delivered as radioactive pellets that are inserted strategically within the prostate

The hormone therapy will kill my libido and diminish much of my virility. That scares me because so much of my business success depends on my drive and energy: to hustle up work, to meet deadlines, to drive myself to do the work I find tedious. Along with this diminished drive comes a host of related issues, like weight gain, increased risk of heart disease, etc. In other words, I would face an uphill battle for the next two years. By the time I was done, I’m afraid that I would come out fragile and diminished.

I feel overwhelmed by these choices. I wish so much that I wasn’t alone going through this. I must turn to my children and close friends, ask them to visit me during the treatment, possibly for up to two years. I’m looking to my friend Lee to keep playing pickleball with me for as long as I am able. I need this to keep me from falling into lethargy and depression.

July 18, 2021

My moods careens from the affirming to the sad as I arrive at a decision, one moment assured, the next full of doubts. There’s no obvious prescription for this. I know I must proceed despite the anguish I feel inside.

I will speak to the surgeon on Monday and schedule a surgery to remove my cancerous prostate.

The radiation oncologist laid out the science, and my consultation with my family doctor brought no greater clarity. Surgery or radiation come out even in their outcomes, given the severity of my cancer. The key differences are that with surgery, the gland is excised and can be examined for signs of metastasis. If the outer walls are intact, we can be sure the cancerous cells have been kept within and there’s no more worry. You cannot have the same assurance with radiation treatment.

Surgery is swift and least disruptive to my livelihood, whereas radiation treatment + hormone suppression will take two years, and possibly a brutal toll on my livelihood. It might be more stressful and deadlier than the disease itself. These arguments won the day in favour of surgery. Whatever else I lose, I win the right to continue living.

My mood swings pull me towards solitude and longing. I know that I crave affection and conversation, but they will not come to me. I feel that I must welcome loneliness and make peace with it. So I turn inward and pursue my own interests. I take walks to Stanley Park or go out by myself to Guilt & Co for live music. The longing remains, like a dull toothache I must live with. I’ve slowly become comfortable with my lone life, though finding company was a good part of why I moved to Vancouver.

I’ve drawn comfort and strength from speaking to other people who’ve had cancer and survived it. That too comes in waves: at times making me strong, other times leaving me alone with my fears. I think that’s why it’s so important to push myself through it, no matter how stressed or frightened inside. I have to come through to the other side.

August 24, 2021

The date for the surgery has been set to September 10. For the past two weeks, I’ve been thinking a lot about what this means. My prostate will be removed via laparoscopy, which only entails small incisions that allow the insertion of surgical instruments and removal from within my body. It’s a 4-hour operation under general anaesthetic and I will stay overnight in the hospital, then have 4–8 weeks of recovery. Depending on the extent of cancer growth, the surgeon might be able to spare the right-side nerve that controls the function of my penis, meaning I should still be able to (eventually) pee normally and have an erection. My sister will come to stay with me for 5 days after the surgery, when I am most impacted by it.

I also learned that the characteristics of my case — early, aggressive cancer, a Jewish mother that had breast cancer — make it very likely that I carry the gene BCRA2, which makes me prone to prostate, pancreas and breast cancer. I’ll have to keep monitoring for it from now on, in order to catch early signs of cancer. I suppose that’s another strike against me.

I had fretted a lot about how I would be diminished, but I am now confident that I will return to a near-normal life. I felt like resuming dating, but I fear that I will be viewed as damaged goods and undesirable, and can expect to live a life alone. I’m struggling to adjust my expectations and prepare for this prospect.

Against this, I feel the strongest, healthiest, more purposeful and alive than at any other time in my life. This is the most attractive I’ll ever be, minus the missing body parts. What a nasty curveball God threw me!

September 10, 2021

My prostatectomy took place on September 10, 2021. It was a 6-hour operation.
I wrote this poem the evening after my surgery.

What poetry could come from this drab hospital room?
No bird songs, no gentle breeze
Only the whirring of machines
An insipid meal on an insipid tray
Blue barf bags, just in case
People coping with ailments and recoveries
Yet, in this room, my life is allowed to return from death

Part 2. After the Surgery

September 12, 2021. Letter to friends

I was discharged today, two days after the prostatectomy. It’s a bit of a wild trip.

I entered the operating room at 8 AM and faced 6 people waiting for me, eager to get going for the 4-hour operation. That it was me, somewhat frightened and apprehensive, was of little concern. I was another patient giving myself to their hands.

Immediately after I lay on the operating table, a person came and pressed a mask to my face, struggling to cover all of my beard. It felt like an assault and I could hear the heart monitor in the operating room beeping upward frantically. My heart beat echoed loudly into everyone’s ears. I told them to hold off and let me compose myself. Then they slowed down, recognized me, and the anaesthetist told me to focus on my breath. I accepted their intervention and disappeared from the world.

I woke up in a hospital room at 3 PM, sore in my cut-up belly and weak. I was pale and exhausted. The anesthetic would take another day to dissipate out of my body, to stop making me groggy, weak and nauseous. I could retain water, but nothing else. I sported a thick catheter coming out of my penis with a long tube leading to the urine bag. This, a dreary hospital bed, was my home for the next two days.

I had no energy for anything, but still managed to walk in the hallway with the nurse that night. I knew that I must activate my bowels, which the anaesthetic had stopped in their tracks, and walking is the best way to do it. After a brief, laborious walk, I settled for the night … only to be closely monitored — meaning woken up every two hours — by the nurses checking my bandages and vital signs or administering fluids and drugs. Near morning, I was awoken again from a restful lapse for another two-hour check, and I couldn’t wait for this charade to end, necessary as it was.

My friend R came the afternoon of the surgery, then again yesterday, and she provided much needed comfort. This became especially important because of the constant rotation of more or less competent nurses, and I felt at their mercy. With R, I had an advocate.

Yesterday was spent regaining my composure. As the anesthetic waned, I felt my strength return and could even use my abdominal muscles to sit myself up, an important milestone. My mind returned to its natural alertness, and with it came a new boredom to endure in this room, with only whirring machines or the raspy, incessant voice of a demented old man in the hallway. That day, I took four walks, felt more secure in my footing, and had everyone marvel at my quick recovery. By the end, I was walking steadily, but felt out of place in this hospital. All the older people nearby were lying in their rooms while I was regaining my vigour and wanted to get going with my life.

R came today, eager to set me free. My vitals were good, there was little fluid released from my abdominal cavity and I could walk decently. We waited until my surgeon arrived at 11 AM, checked me and declared me free to go. Quick change of bandages, a shower, and I was outta there.

Here I am, a few hours later, set to resume my life. My immediate concern is walking around with a urine bag on my leg, then later with learning to contain my urine normally with my bladder, still later to regain my full sexual function. That’s the longer road ahead, along with how I will live from hereon. For now, a good homecooked meal is the best thing to have happened in the past few days.

September 16, 2021. Text to Lee

I’m progressing well in my recovery. My sister stayed with me from the day before surgery until this morning. Her presence was a godsend, allowing me to focus on regaining my strength, as well as getting control of the pee bag system. I now feel ready to look after myself.

I had my first shower at home today, the first time in six days, and it felt divine! The bandages covering my surgical wounds had been removed and I no longer feared wetting them or my uncovered wounds. Already, the skin they protected is well healed, following its natural desire to be whole. I tilted my head, relaxed the strained muscles that protected my weak, wounded belly for the past five days, and let the warm water run over me. It felt extraordinarily soothing to have it caress my naked body. I soaped and washed myself, brought back my clean skin, and it gave great pleasure to feel normal again.

I now measure my progress in feet. Today, I walked as far as the hardware store to get a duplicate set of keys. I stopped on the way home and sat in the sun, taking in its heat. Coming back home, I had a nap.

September 22, 2021. Text to Katie

Tomorrow is a big day for me, one that I can’t help but dread.

I have an appointment in the morning with the surgeon. He will remove the catheter that’s been increasingly annoying to me, but, most importantly, he will report the results from Pathology, where they examined the prostate and lymph nodes that were surgically removed. The lymph nodes will either be clear, indicating that the malignancy was confined to the prostate, or they will indicate that it had begun spreading to other tissues. In the first case, I’m free and clear of the disease. In the second case, I will need to undergo further treatment.

Wish me luck.

What time is appt?

9:30 AM. I’m disappearing in bed. Can’t bring myself to do anything tonight.

September 23, 2021. Text to Katie

No pathology report yet. Need to wait six weeks.

Sheesh!

Doesn’t matter. I’m too wiped to care. The catheter is out and I am leaking urine, but I don’t care. Leaking is better than draining through a tube.

September 27, 2021. Text to Lee

I had the catheter removed 4 days ago and am re-learning to be continent. Already, I have regained control of urine flow while sleeping horizontally, but I lose control when I become vertical, from sitting or standing. I’m encouraged by my progress, while accepting that there are still weeks to go before I get back to normal. I’m feeling optimistic and vigorous.

I’m back to normal as far as work is concerned and am feeling productive. That feels good too. It won’t be long before I’m ready to go play pickleball again.

October 7, 202. Text from Katie

(Pathology report: margins are clear. The cancer was confined to the prostate)

Just picked up yer message. 🥳🥳🥳😁

Fabulous news!!

I’m SOOOOOO HAPPY FOR YOU!!!!!

Woohoo!

Raki for celebration!

October 27, 2021

At first, I was always incontinent
Dripping like leaky eaves.
But I’m getting better.
This morning I had a coffee.
(decaf, not taking chances)
Now the urine flows
Like the mighty Fraser River
When I’m good and ready to pee!

November 10, 2021. Post to Facebook Prostate Cancer Support Group

Lately, I focussed on my morning coffee to improve control of urine flow. I tried decaf, but it doesn’t feel like it makes much difference. However, I’ve noticed a great improvement going from two cups to one cup per morning.

I also know that a glass of wine doesn’t harm me too much, but two will. One pint of beer is a disaster.

Has anyone one else played around with morning coffee or food & beverages to help their incontinence? Anyone have helpful tips for this group?

November 14, 2021

It’s been a long walk already and I’m soaking in warm urine. My pad is pretty saturated and each new trickle runs along my penis, bathes my testicles. Everything feels irritated, urgent. I’m not too far from my apartment and I’m pretty sure I can make the next blocks without further damage.

I tighten my floor muscles and walk purposefully down the alley, towards my place, but I still leak. Today, the damn thing has a mind of its own, like a faucet stubbornly resisting being shut tight. The elevator ride is interminable, but I make it to my floor, unlock my door and fling everything inside. I rush to the toilet, strip off my clothes and catch a breath of relief. The air feels nice on my exposed, soaked penis. I try to press more urine out of my bladder, but there’s only a few drops coming out. I feel drained, not of urine, but of the constant struggle to contain everything, to keep from getting to that place, here, where I marinate myself in my own urine.

Finally, I get off the toilet, turn on the shower, step into the warm water, and thoroughly wash myself. That’s when I finally let go of all tensions, finally feel clean again. I stay longer than I need, luxuriate in this fresh cleanliness. In a moment, I will dry myself, put on a new pad, and start all over again.

November 26, 2021

Another Friday night at home.

I could have tried to go out, but today doesn’t feel safe. Not being out that long. I was OK the week before, when I went to Tutto’s for dinner and remembered what it felt like to go out Friday night. I caught the full moon walking over, feeling like I’m part of the world again. I dressed well too — jacket and dress shoes — but it was only for myself.

The place was hopping; so many young men trying to impress their dates, a thousand year-old ritual. I just watched them from afar. I wouldn’t *ever* consider dating, not in my present condition. How would I explain that I needed to go to the bathroom for the third time since we arrived, from fear of saturating my pad and flooding my pants? How can I feel attractive in these circumstances?

And yet I would love company. I would love to pretend that all is well, that I am still desirable, youthful, diminished as I am. How can I keep it real, cuddling on the couch, kissing, then suddenly stop to say: “Excuse me, I have to go to the bathroom” and know that it’s ok?

December 3, 2021

What does incontinence feel like?

It’s like your nose dripping, either from a flu or from going outside in the cold. Except that there’s no cold: it just drips on its own, for no reason.

By itself, it’s not a big deal. I wear a pad in my underwear to retain the urine. I change the pad when it’s soaked. However, it puts a restriction on what I can do. One coffee in the morning is fine, two is not. A hike in the woods is limited to three hours, the time it takes to saturate the pad. Dinner out with a date isn’t completely relaxed, as I become super-aware of every trickle as we chat. When we part, a hug presses an extra squirt out of my bladder, making it clear that bringing my date home is a perilous idea.

My incontinence is like a leash: it limits the extent of my freedom. I can’t wait for it to be over.

December 8, 2021

I know I’ve given up erections,
Perhaps for a while, perhaps for much longer.
I know that I piss like a punctured hose,
That I fret and worry about going for a walk.
But I get to keep the sunsets,
I get to keep the summer breeze,
And I get to keep the voice
Of the sweet woman who loves me.

December 28, 2021

I thought long and hard about the treatment for my cancer. Mostly, I thought about the consequences.

I’m single, so I asked myself: how would incontinence and losing erections affect dating? Was I setting myself to live a solitary life?

The real question was: what am I afraid of?

And the answer was: I’m afraid that people will not treat me with dignity.

Eventually, I decided that I would be fine. I did not resign myself to the lesser of two evils. No. I came to accept that even if diminished, I will not lose my dignity and self-respect.

I now realize that when I accepted myself, I made it that nobody could take it away from me. I can carry on.

This is how I vanquished my cancer.