My Body

May 26, 2002, New York

I'm trying something new today. For the first time, I'm dictating my journal entry. My brother is kindly typing in these words because I'm too tired right now to sit up and write.

This past week I was supposed to be getting cancer treatment in Chicago. So much for the best-laid plans. As it turns out, I was holed up for nine days at Beth Israel Hospital in New York, fighting off a variety of cancer-related maladies--shortness of breath, abdominal pain, anemia, bowel obstruction, and pneumonia. I just got released yesterday.

I landed at Beth Israel out of sheer desperation. After leaving Memorial Sloan-Kettering two weeks ago, I realized I needed a new team of local doctors who would be willing to complement my efforts in Chicago. Through the recommendation of a friend, I found such a group at Beth Israel.

But just when I was ready to implement my plan, my energy level began to sag. I started feeling shorter and shorter of breath. Finally, it reached the point where it became a major undertaking just to walk from my bedroom to the living room. I realized I needed to check myself back in to the hospital, pronto.

After a series of tests, the doctors at Beth Israel came to many of the same conclusions as those at Sloan-Kettering--namely, that I had an inoperable bowel obstruction and would need to receive all of my nutrition intravenously. The doctors at Beth Israel, like those in Chicago, agreed that I should begin an intravenous feeding program called TPN (total parenteral nutrition). It bypasses my whole gastrointenstinal system and essentially pumps baby formula into my veins around the clock. (Sloan-Kettering had been unwilling to give me TPN in the belief that it simply fed the cancer.) I now carry a ten-pound bag of TPN in a backpack as my constant companion; where I go, it goes.

The hope is that TPN will rebuild my strength to the point where I can withstand a more stringent regiment of chemotherapy. If the chemotherapy works, it will degrade the tumors enough to clear the bowel obstruction and allow me to resume normal eating. That's the hope. Keep your fingers crossed.

As I was changing out of my hospital gown before leaving, I stood before the mirror and looked at the state of my body. Even I could hardly recognize myself. Where before I retained some weight in my face, all of that was now gone. My face looks skeletal. My cheeks are hollow. My eyes look sunken. My jaw-line is taut. My neck is scrawny like a turkey's. My adam's apple juts out.

My torso looks not unlike those pictures you see of the severly malnourished--basically, a collection of bones held together by a tight wrapping of skin. You can see clear definition of every rib. My belly is round and hard and sticks out like a small basketball. My hips and pelvis have no meat on them. My ass has lost all its fat, to the point where it hurts to sit for a prolonged period because I'm sitting straight on my bones. My legs are bony as well, with knobby knees and no calves, and my feet are swollen.

My visage brought to mind a famous writing by the 15th century zen master Ikkyu, a poem/essay called "Skeletons":

Who will not end up as a skeleton?... Have a good look--stop the breath, peel off the skin, and everybody ends up looking the same. No matter how long you live, the result is not altered.

When I think of all that my body has gone through over the last year, it's no wonder it looks the way it does. I've got a huge scar across my abdomen, with six or so smaller scars surrounding it from various other procedures. I've got a port lodged under my skin near my collarbone that connects directly to a vein in my neck for the TPN. I've been stuck with more needles than I can possibly remember. I've had all kinds of instruments crammed down my throat, jammed up my nose, stuck in my belly, and pushed up my rectum. I've been zapped with radiation from X-rays and swallowed cupfuls of barium and "contrast solutions" for CT scans. I've had all manner of toxins poured into my veins and belly. Not to mention a major organ ressected and my whole gastrointestinal tract rejiggered.

My mom tried to get me to turn away from looking anymore, but I wasn't saddened by what I saw. I love my body. Now more than ever. I love everything it has left. I love everything it's given me--every sensation, experience, presence, intimacy--every movement through time. I've had a great ride in this body and I'm greedy--yes, greedy--for so much more. I want to grow old together with my wife. I want to help my children grow. I want to hold my grandchildren. And I want to do it in this body, this body that's given me so much fulfillment already.

It saddens me to think of all those people in the world who for whatever reason dislike their bodies, people who don't realize the precious gift they've been given. "If you've got your health, you've got your wealth," my old colleague used to say. Gratitude can start in the simplest of ways.

I don't know if the TPN program will work. I don't know whether I'll get to Chicago. But I'm going to try. My body may look frail, but my eyes, I think, look quite alive. And as long as I have a voice in this world, I'm going to use it. My spirit wants to ascend.

As the martial arts adage goes, "Seven times down, eight times up." Once again, I have to pick myself off the mat.

C'mon, body, let's start over. Baby steps and patience. We gotta do it.