something like quiet...

Michelangelo Merisi da Caravaggio.The Supper at Emmaus, 1601. (Currently on loan to the Art Institute of Chicago.) It's always better to see his work in the intended location, such as a small niche in Rome...but it's still worth a visit to see such a powerful work here in Chicago.

All too lately, I start off my entries in this manner...making a statement about how much I’ve been working without the time to write, etc. etc… I often wonder if this is true. Well yes, the constant working is true… but what is the motive? Am I secretly avoiding something by always trying to move forward at breakneck speed? It’s much easier to bury your head in the sand and commit to your business, all the while, neglecting the real matter at hand… the elephant in the room… the baby on the door step… the time bomb ticking inside of me… ticking this wretch of blood and pumping with so much eager activity under the skin, rooted in the organs, chewing little by little at the whole thing that is me. I love what I do… I love the chaos and the score and the projects and pushing the edge of every last minute… but… but…there’s always that other thing that wants to crop its head up and call for attention. No matter how much I try, it’s there like a shadow, inescapable. I’m physically and emotionally exhausted from looking over my shoulder. I’m not sick… not yet, it’s not that kind of tired. It’s something not quite explicable.

Nevertheless, here we are. Here I am, writing. I met with Dr. Benson on Friday to discuss my progress and local care. Benson made it clear from the beginning that he was not a fan of aggressive action and/or surgery, without definitive results (i.e. a cure or symptom relief). A cure is not an option for me at this time. However, it was not until this week that Benson’s case became a little clearer to me (frankly, I think I’ve new found respect for Dr. Benson’s philosophy). He made a well fashioned argument that surgery, in fact, may not stop the progression of my disease (depressing as fuck) ((FYI you can say “fuck” whenever you want when you have Cancer)). His argument was so persuasive that it basically fucked up the little Dr. Warner/Shafir microcosm that I’ve been living in these last few months. I haven’t given up the surgery option yet, but I have decided to seek another opinion from the intervention radiology / surgical team at Northwestern.

Unlike other Cancers, such as lung, breast, etc., the path for management is less clear. It’s not a mainstream disease, which means that there are fewer proven courses and guidelines. My disease appears to be stable at the moment, but there are some new areas of tumor growth in the liver that are of concern. This disease is NOT stagnant and as even Benson noted, highly variable. From external scans, I have +/- 17 liver tumors of varying sizes, the largest of which are the size of a lime and a walnut (strange bedfellows indeed). All of my doctors have made some comment to the effect that, “what we see on the outside is often not the whole story…” the rest is revealed when they open you up. In most cases, it’s worse… so, that’s not promising. Much like before things are still undefined and my treatment is unclear. It’s a frustrating process, and after nearly a year, there are still many questions that lack sufficient answer.

Recently, something dawned on me… How could I forget? My surgery is scheduled for November 18th… That’s a date I never forget. I’m not one for horoscopes, superstition, or magic stones, but I do respect history. I respect the time and air between space that forms years. My religion is the push and pull of memory that is infant and ancient. When I was fourteen, on November 18th, 1994, I took the train From Milford to Norwalk, CT. I missed my stop and ended up wandering the streets of South Norwalk in the pouring rain. Eventually, soaking wet, I found a pay phone and called my uncle George, who somehow, managed to find me. Shortly there after, I was cruising the town with my cousin Jim, Ryan, and some other friends. A few laps at the ice rink, a burger at McDonalds… I’m sure it was hours, but in my mind, the whole night was just a minute… because the next thing I remember was a twist of the car so fast followed by a chilling crunch. -metal and glass so hard...bursting. But I remember this clearly: the extreme silence after the clash. I could bathe in that silence for a century. All I could think and smell was gasoline… “get the fuck out…” I’ve never felt pain like that before in my life and still haven’t. There was an extreme fire-ache in my legs, and as I lay on the wet concrete, I stared up at the trees and the blood in my head throbbed against the cold asphalt… no drug ever made me feel like that… I’ve never tripped so hard. (And yes my dear parents, if you’re reading this, I did drop acid as a teen… and yes, I liked it.) I had never been so cold… in so much pain… and yet, so calm, amidst the sirens and moans and everything else. That quiet was disturbed in the emergency room when I saw the faces of my family… I could see it so clearly… I knew without words, that Ryan, who was driving the car, was dead. Without a noise, without lips moving, everyone was screaming…but they kept it to themselves in those early morning hours. Sad at the loss of another child, realizing it could have easily been their own; grateful that is was not. The real pain is numb and soft. The real screams make no noise.

And so, how could I forget this date? I guess I was caught up in another rhythm. Is it poetic? Is it coincidence or cosmic mischief? Most likely it is neither... It just is…Nothing more, nothing less. I don’t recount that event to stir up personal trauma, regret or anything of that manner. I’ve taken the incident for what it was, a wake-up call that life is indeed fragile and the universe unforgiving. And now coming on 15 years later, that strange truth is still just as vivid as I deal with Cancer. Be it a telephone pole or a tumor, the ticking never stops and history has no patience for those who dawdle. And therefore, I move forward only with a hazy imprint of that night written on my body.


Read this article… they note “one of our 40 year old, younger patients…” Makes me want to vomit, since I’m 11 years off from 40… It should also be noted that I have advanced disease. That is, the Cancer has spread to distant sites and is unresectable. This is important because it relates to prognosis and changes how the disease can be managed. To read other recent articles, visit: http://www.caringforcarcinoid.org/news/breakingnews.asp