Liver Update, Surgery Planned

The palliative care doctor who's taken over my case while my regular oncologist is away came to our house today. She came to examine me and talk about the liver ultrasound result.

She said the scan showed the largest tumor from the previous scan has grown from 3.8 to more than 4 cm, but she couldn't tell me anything about whether the number of lesions has increased or by how much. She also said the fluid in my lungs has increased. I'm not sure how they could tell that from a liver ultrasound, but there it is. These are just preliminary results so we might get more details later.

Meanwhile, the doctor suspects that although it's the liver causing most of my problems, I also have an inflamed gall bladder that may be exacerbating the pain and nausea. So I'm going to have the gall bladder removed.

But because I've lost so much weight lately, the surgeon is afraid I may not be strong enough to withstand the surgery, so they've now put me on a course of antibiotics to help the inflamed gall bladder settle so I can eat and put on some weight before I get the surgery. So I guess I'm like the Christmas turkey - they're fattening me up before they cut me open.

I'm just happy we finally have a course of action. There's nothing worse than sitting around in limbo, waiting to feel better without being able to do anything to actually make that happen. So that's the plan for now.

A Simple Gift

I haven't posted anything for the past week because the pain and nausea have been so bad that I haven't been able to do much. We've spent the past five days playing around with different combinations and permutations of pain and nausea medication, but we just can't seem to get it right. I've started losing weight again because the mere thought of eating makes me queasy, and this is worrying me since I have to keep my body strong enough for chemo.

I finally decided a few days ago to get a liver ultrasound, even though my regular oncologist isn't back yet from her holiday break. I'll call in tomorrow to see what the results show. I had a quick peek at the monitor as the technician was scanning my liver and it looked like Swiss cheese to me. But I'll try to hold off on any conclusions, especially those involving food-related similes, until I see the actual report.

The long-term plan will be to find another chemo combination that will work if this one's not doing the job. The immediate plan is to find a way to stop this pain and nausea so I can have a quality of life worth preserving with the chemo in the first place.

It's easy enough to tell people to be strong and persist. Maybe on a short-term basis, physical pain can be overcome. But when the pain and discomfort are constant so that you can't think about anything else, they really take life away from you. I've given birth twice. I'd rather do that all over again than deal with this. Yes, even without the epidural.

The worst of it all is the effect on the family. I haven't been able to play with my kids or their cousins who are visiting from the U.S. I haven't been able to help Tony with things around the house to keep his family happy. On Christmas day, it was all I could do to sit up straight without falling over as the kids opened their gifts.

By the way, those of you who gave us gifts, could you please let me know what you gave? Normally, I'd write down who each gift came from so we can say thank-you. But I wasn't able to do that and now we have a houseful of very generous gifts and I have no idea whom to thank for them. Not only that, we still have a bagful of gifts that we have to hand out to the neighborhood kids that I haven't been able to organize. Poor Tony has enough to deal with these days. So if your kids haven't received their gifts from us yet, please come by and we can give them to you.

I'm sorry I don't have anything very cheerful or festive to say. How's this... Lucky for you, you have your health and your family to enjoy it with. Don't underestimate the value of something as simple as being pain-free. Relish that you can eat, that you can pick up and hug your kids, that you can make your spouse smile instead of look sad, that you can walk and talk without running out of breath. There are so many delicious things in life that you still have that I see I'm losing now (only temporarily, I hope!). Play that out-of-body game and be me for a few minutes. Then go back to being you. Aah. No pain... That must feel good. There's my gift to you this holiday season. Merry Christmas!

Rhetorical To Real

"How many times do I have to ask you? What did I just say? Did you hear me? What did you do that for? What were you thinking?"

These are rhetorical questions parents ask when their kids do something wrong. We never expect an answer; in fact, we don't even give them a chance to answer. I've realized this and decided I'm going to change that.

Toby's still too young, but with Josie, I can have a discussion launched from these questions and really give her a chance to respond.

A while ago, she was jumping on my bed so I asked her to stop. She kept doing it. I said, "Josie, I just asked you to stop jumping on the bed. Why did you keep doing it?" And then I made eye contact with her and waited for an answer. When she saw that I was actually asking for an answer and not just throwing those questions out to scold her, she really thought about it and explained herself to me.

She got a chance to reflect on and explain her behavior and I got a little look into her mind and reasoning process. Win-win situation. Not only that, she doesn't always ignore those types of rhetorical questions from me anymore; she actually stops sometimes to think about what I asked and tries to answer.

This is a pretty mature thinking process, this type of self-reflection. If we, as adults, asked ourselves similar questions about our own behavior and choices, we might be stumped. Why did I just have that drink when I know I've already had too many? Why did I do that? Why did I agree to go out with that guy when I know he's no good for me? What was I thinking? Why am I taking this job when I know it's going to make me miserable? How many times have I made this mistake before?

If we forced ourselves to stop, really reflect upon, and answer these questions, we might come up with some helpful answers, just as our kids can if we give them a chance to respond instead of throwing out empty, meaningless questions at them.

Meet Me In Heaven

One of my favorite songs is by Pearl Jam, with these lines:

"Oh where oh where could my baby be
The lord took her away from me
She's gone to heaven so I've got to be good
So I can see my baby when I leave this world."

Toby likes to sing this song - very cute coming from a three-year-old. What a hip pre-schooler!

It's a nice thought that you try to be a good person so you can go to heaven when you die and be with a loved one who was taken from you. Of course, the kids could grow up to think that maybe their mother isn't in heaven but elsewhere, in which case they could use that excuse to do wicked things so they can see me in "that other place" after they die...

To hear the song, click HERE.

Coal In My Stocking

For the past week or so, I've had more nausea and stomach pain than usual, but I thought they were just side-effects of the drugs I'm on or the cancer cells taking nibbles at me. I went to see the doctor today to get a post-chemo blood count (counts all good - yay!) and asked about my symptoms while I was there. I asked if the pain and nausea might be due to ulcers caused by the steroids I've been on since August - a long time to be on steroids. I suggested we do an endoscopy to find out.

She said that if an endoscopy showed I had ulcers, the treatment would be Nexium, Zantac, and Maxolon - drugs that I'd already been taking, which didn't work. There was a chance that it was a different kind of ulcer caused by the Helicobacter pylori bacterium, and if that were the case, the treatment would be two antibiotics and a "proton pump inhibitor", a type of drug that reduces gastric acid production in the stomach.

An endoscopy costs S$300-400 (US$200-275). I didn't want to spend that kind of money.

Then the doctor did a physical examination to locate exactly where the stomach pains were. Luckily, I'm a grown-up and can be a bit more precise than "I have a tummy ache." As she tapped away and asked for my responses, she started shaking her head. Her conclusion? It's not an ulcer at all. It's my liver. My biggest worry.

Liver failure, apparently, is the most painful way to die. If you die of lung failure, there's still a chance you can expire with grace and dignity, like in the movies. Deep breath, gentle closing of eyes, quotable sentimental words, then fade out to black. But with liver failure, there's groaning and moaning, agony and excruciating pain. So unladylike! Not to mention the trauma and stress on the family.

So here's our situation at the moment. My liver's not doing so well. I'll have my liver scanned with an ultrasound when my regular oncologist returns from her vacation.

Meanwhile, the only thing we can do is treat the symptoms. We've now upped the anti-nausea ante to Motilium, and if that's not enough, I have Kytril as a back-up, but these tiny pills are S$30 (US$21) per pill! Now that hurts! For pain, I've now moved on to morphine from the codeine-paracetamol combo I was on. Let's see if these drug changes make any difference. I used to be so adverse to taking pills for any reason. Now, they're my main source of food.

Today, I actually ingested more pills than food. No kidding. Food tally: about four noodles (not bowlfuls, but actual strands of noodles) with two small squares of cabbage in a clear broth, one bite of pizza crust, and two digestive biscuits. Pill tally: more than 20 pills for seizures, pain, nausea, breathing problems, hand-foot syndrome, protein support.

A friend of mine got laid off last week and I told him the timing really stank. Who would fire somebody just before Christmas? He said, "Well, it could be worse. I could have cancer." Now here I am with some lousy news. Well, it could be worse. I could lose my sense of humor and think my friend's comment wasn't funny. Now that would be truly tragic. But he made me laugh. Hey, I can still laugh.

A Tale of Two Tales

Tale Number One:

Tony came back from the supermarket yesterday after doing the food shopping, then fired up the barbecue and made lunch for the nine of us (visiting in-laws). He gave me a hamburger as I requested, but instead of expressing my gratitude, I told him it was silly to give me half a burger with a whole bun, plus I wanted onion, and when I got the slice of onion, it was a circle rather than a semi-circle so it wouldn't fit onto my burger, plus he'd cut the onion on our wooden cutting board, which I'd told him leaves an onion taste that will transfer to any fruit we cut on the board later on. So here he had gone through all this trouble to make me happy and instead of being thankful, all I could do was come up with reasons to criticize everything he did.

Tale Number Two:

Just after the incident described above, Josie was jumping on a side table in our living room and I saw that it could be quite dangerous, especially for her little cousin who's staying with us and copying everything Josie does. So I asked Tony if there was somewhere else he could put the table that was safer for the kids. He angrily grabbed the table, threw everything off it and shoved the table into a corner. I asked in a challenging, emotional voice, why he was acting so strangely and why he couldn't just listen to me and answer my question instead of being so rude and dismissive. I told him he was being unreasonable when all I wanted to do was solve a problem. All this in front of his entire family, including the kids. I persisted in asking him to respond with some explanation until he finally just walked out of the house.

Multiple choice question. Which of the following best describes the situation above?

A) Tony was being unreasonable - all he had to do was suggest a safer place to put the table.
B) I was being ungrateful - I could have thanked him for his troubles instead of criticizing every little thing he did.
C) Tony should have listened to me instead of dismissing me and ignoring me.
D) I should have given him some space instead of haranguing him while he was feeling besieged by my criticisms.
E) All of the above.

I'm not sure which of the two stories makes me look more sympathetic and Tony look like the villain, but I pick that one, whichever it is. I'd really like to lick my wounds and have my actions vindicated. Poor Shin. Bad Tony. But that's too simple and silly.

All couples have communication challenges. Tony and I certainly have our share. I have my own communication issues now because I can't express myself as well as I'd like, due to the cancer and various side effects. One of my favorite strategies in an argument is to diffuse the tense moment with some humor or a compliment. That takes a certain control of voice, tone, a mischievous smile or flirtatious wink. I don't have many of those at my disposal these days.

But this stymied style of mine is also a reason to open my ears and think a bit more. If I had been a bit more breathless yesterday and really couldn't speak at all, I might have kept my mouth shut and given Tony the silence he needed instead of pushing him to answer me.

I wish I could say cancer has given me new wisdom and depth of understanding about myself and my relationships, but it hasn't. I'm still making mistakes and I'm still fixing them. I'm Bob the Builder. Can we fix it? Yes we can! I'm a work in progress. Aren't we all?

Toby's Tears

Yesterday, we had a minor scare when this silly cancer patient decided to climb on top of two suitcases to put a dangerous toy out of toddlers' reach. I lost my balance and toppled down, landing on my back. I've seen enough movies and TV to know that when you land on your back, you don't move, just in case you've done something to your spine.

The noise I made on the way down - the suitcases tumbling down on top of each other, me landing on the toys littering the floor, a number of things - caused an almighty crash; much louder than the actual danger represented. My in-laws, who are here visiting from the U.S., sounded the alarm and Tony, Josie, and Nana came running in from the pool, dripping wet and scared.

The reaction that really made an impression on me was Toby's. He was in the room when I fell, and the first thing I remember when I found myself lying on that floor was little Toby sitting by my side, his arms around my neck, crying softly and saying, "Mommy? Mommy?"

These were new tears that I'd never seen from Toby before. I've seen angry, frustrated tears, tantrum tears, sad tears. But these were scared tears. The poor little guy was frightened for his mommy. He knew I was hurt (the noise must've really startled him) and he wanted to take care of me but didn't know how.

There are some lessons I've taken away from this incident:

1) Toby is not oblivious to my weakened condition and notices when I need help.

2) Toby has a soft heart for his mommy, even though he acts like a toughie.

3) I need to stop climbing on suitcases.

Medical Journals

I had a friend who gave her daughter some prescribed medication one morning. Her husband didn't know she'd already done it so he did the same thing. The poor child ended up in the hospital. Adults take a double dose of something and might feel a bit ill. You do that to an infant and it can cause serious harm. Keeping a medical diary will ensure that you don't overdose your child.

I keep a medical diary for each of my kids. Whenever I give them any medication, I write it down - the name of the drug, the dose, what time I gave it. I jot down their symptoms, their temperature, anything else that might be relevant or helpful to the doctor if I end up having to take them to the hospital.

These records will also provide a thorough medical history for years on down the line. There's no way I'll be able to remember every case of chicken pox or shingles, Hand-Foot-Mouth, flu, bronchitis or allergic reaction my kids have had. Keeping a record has even helped us see some patterns developing.

I keep a medical diary for myself as well - pretty good idea for anyone, but especially for people with a chronic condition like cancer. Since my diagnosis three years ago, I've kept a medical diary with notes of doctors' meetings, my treatments, drugs, doses, blood counts, weight, oxygen saturation level, and other relevant vital statistics.

I've also kept a binder with copies of every formal medical report, starting with my histology/pathology report diagnosing my cancer. In that binder are radiologist reports, tumor marker tests, blood count reports, and other medical records tracking my cancer. This information has been extremely helpful to me and to my doctors.

Remember, you're just one of hundreds of patients your doctor sees in a year. Don't expect him to remember everything about your medical history, even if he does have your file open in front of you. He might just be doodling when you think he's writing notes about your symptoms.

Sorry Tears

I was showing Josie how to send an e-mail and she kept trying to tap random keys instead of listening to my instructions on what she should do next. I got frustrated and snapped at her, "Would you please just stop and listen to me?"

There must have been something in my tone of voice that really hurt her because she immediately stopped and sat still with her head down. Just seeing her like that broke my heart. I don't think she was upset that she'd done something wrong. She wasn't upset that I yelled at her because I didn't really raise my voice very much. I think what really hurt her was the feeling that her mother wasn't pleased with her.

Later that night when I was tucking her into bed, I said, "Josie I'm so sorry about snapping at you earlier today. I still feel really bad about that."

She answered with a very tiny sad voice, "Mommy, please let's stop talking about that because it's making me very sad."

I think I sometimes forget how sensitive Josie can be. I think of her as a tough girl and often remind her that she's tough, like her mother. But sometimes just a harsh word or a feeling that I'm not pleased with her for some reason cuts into her worse than any scolding, time-out, or other punishment.

I have to keep this in mind. These are not the kinds of memories I want her to have of me. I don't want her heart to ache at the thought that she had displeased me in some way.

Brain MRI Results

Good news! I got the results of my brain MRI yesterday and the films show the tumors have almost completely disappeared. The photos on the left are from August and those on the right are from Wednesday. The doctor said this could mean that 1) the tumors are on their way to shrinking down even further, or 2) the tumors are on their way to resuming growth. I'm going to choose door number one.

This was a follow-up scan after the seizures I had in August due to the growing tumors in my brain. I had whole-brain radiation for ten days after that. We'll wait another three months now and do another MRI to see whether the tumors are coming or going.

These MRI results were exactly what I expected. At the risk of sounding cocky, I have to say I've been uncannily accurate about the progress of my cancer for the past few years. In terms of predicting results of scans or the effectiveness of treatments, I've had a better batting average than even my doctors.

For example, for months last year, I was put on various different antibiotics for lung infections and the entire time I kept saying it was cancer, not infection. When we finally did a biopsy and my self-diagnosis proved correct (unfortunately), I was the only person in the room to react with dry eyes and no surprise. It pays to be prepared.

Given my success at reading my own body and disease, I'm going to guess that the current chemo combination is working at least enough to keep the cancer from progressing too much too quickly. The pains and side-effects I've been feeling might be due to the interaction of so many drugs swirling around inside my body. I stopped taking the new pain killers and gastritis (inflammation of stomach lining) medications my doctor gave me after my last chemo session and I've been feeling better. Those drugs just didn't work for me; they might have even caused more pain.

Another good sign: for the past two days, I've felt strong enough to get around without the wheelchair, and although I had a few coughing fits that probably scared or disturbed people around me, I didn't end up gasping for air and having a panic attack. Hooray. Looks like Christmas has come early for me!

Cancer Follow-Up, Survival

Since I was diagnosed with breast cancer, I've met many other breast cancer patients and survivors. There are as many different ways of dealing with cancer as there are personalities. Some women want to know everything about their cancer; some want to know nothing. Some are conscientious and participate in their treatment; some want to leave everything to the doctors.

I know every woman has the right to handle her disease and treatment in her own way, but I can't help feeling frustrated about cases where a patient compromises her chances of survival or even hastens her death by not taking an active interest in her own health.

I had a friend who was diagnosed with breast cancer in the U.K. nine years ago. She was treated there and a few years later, moved to Singapore. She didn't go for any check-ups once here. She told me her doctor in the U.K. didn't give her any follow-up schedule, so she assumed she was finished with cancer. Somebody finally convinced her to go for a check-up a few years ago. They found her cancer had come back and spread to other organs. She died last year.

I know other women who have similar stories. They don't follow up; they take bad advice from doctors; they don't seek second opinions or question their doctors. I'm pretty sure some of these women died or suffered unnecessarily as a result.

In the U.S., doctors and patients are far more conscientious about follow-ups after treatment than they are in Europe. A new research study that came out earlier this year showed that breast cancer patients in the U.S. had a five-year survival rate of 84%, compared to 70% for the U.K. Luckily, my doctor follows the U.S. protocol, but even if she didn't, I'd insist on it.

I wish other cancer patients would take more of an interest in their treatment. I wish they'd realize that no doctor will care about them as much as they'd like to think. I wish they'd realize that doctors make mistakes, that some doctors are more competent than others, that some doctors just don't care as much about their patients as others, that you cannot surrender your life to strangers whose motivation for treating you for a killer illness is that they get paid to do it. It's their job. Glorify it all you want, but to them, it's still a job and you're still just one of hundreds and hundreds of patients they see each year.

Cancer patients, please, think, think, think. This is your LIFE you're dealing with. After your treatment is finished, schedule your own follow-ups. Don't leave it to your doctor to tell you what to do. There's plenty of information on the Internet and in libraries and bookstores to guide you on how to go about taking care of yourself after your treatment's completed, so you have the best chance of fighting your cancer if it should ever come back.

Don't leave it until it's too late like my friend who died last year.

Control Freak. So?

People might consider me a control freak, though no one's ever had the balls to say it to my face. Or they're too polite because they think it's an insult. But why is it a bad thing to want to have control over your life? Would you prefer the alternative - lack of control?

Control is the first thing you have to give up when you have cancer. First of all, because you now have a disease you have no control over. Those cancer cells will do what they want, and you and your doctors will do your best but cancer won't listen to reason and step aside just because you want to control those little microbits of death and destruction.

As you go through treatment and the attending pain and weakness, you have to give up more and more control of your life as you knew it. For me, the hardest thing has been letting go control over the kids. There; I've said it. Control over the kids. Today's parenting literature would tell you that we don't control our children, we guide them. Whatever. I'm not fooled by the language. In the end, it means getting our kids to behave the way we want.

But Toby yells rudely to his friend and gets away with it because I don't have the strength or breath to sit down and talk to him about why that's wrong. Josie makes a fuss about trying something new and I'm too weak and breathless to encourage her with smiles and funny jokes.

Before cancer made me so weak and breathless, I'd say eighty percent of my parenting was talking; now it's only about ten percent. I wonder what mute parents do? That must be so hard.

I think that's what lies at the heart of my loss of control: the inability to speak as much as I used to. I can't argue with Tony anymore, so he gets to decide almost everything now, from family finances to what the kids can have for dinner. I used to argue circles around him until he got so dizzy he just let me have my way. No more of that.

And then there's the control over my identity. I used to be a chatty, gregarious, out-going, entertaining person. If someone who didn't know me B.C. (before cancer) met me now, they'd think I was a dull, quiet, shy bore - in my mind, the worst thing a person can be. A piece of furniture. Background. Wallpaper. Ugh. That's what I've become.

I used to know every kid in our neighborhood by name. I used to know who took ballet, who was learning Chinese, which schools they all went to. Now I don't spend any time outside with the kids so I haven't kept up with their lives and can't ask them how their recital went or how their new baby brother is doing.

Same for Toby's kindergarten. I used to walk around the building and call out hellos to the kids. Sometimes they'd look surprised and delighted that I knew their names and asked about them - the way kids do when adults take an interest in them. But now I'm just this frail lady with a funny bald head.

So I've lost control over my persona, my kids, my husband, my body. If you lost all that, wouldn't you freak?

Third Anniversary

Today is the third anniversary of my diagnosis. This is the date I'll mark from now on, so that I'll know how many years I've survived cancer. And silly me, I forgot it until a reader sent me a congratulatory message.

I could consider it a second birthday, if I think of my life with cancer as a re-birth, a new chance at life with deeper knowledge of self and awareness of my mortality. Sounds good, anyway.

The medical highlights of this past year with cancer:

1) I learned my cancer has spread to my lungs, liver, brain, bones, soft tissue, and lymph nodes.

2) I had a lung biopsy that nearly killed me because I was mistakenly given more than twice the necessary dose of anesthetic during the procedure.

3) I had brain seizures caused by tumors in my brain and had whole-brain radiation.

4) I went through ten different chemo combinations.

Things I've learned this year:

1) I can drag out my dying for a while yet. We can't tell whether I'll last another month or another year.

2) Because of the above, it's still hard to take dying really seriously - for me and for people around me.

3) I've done something useful with this blog.

Dreams Versus Goals

I was commissioned to write an article for a lifestyle magazine here in Singapore (actually, I think it may just be online, not print). The topic was how I, as a cancer patient, am facing the new year. What are my hopes, dreams, and fears for the coming year. I was okay talking about my hopes and fears, but when it came to dreams, I had little to say.

The word "dream" has always tripped me up a bit. I never really had any dreams growing up. Kids dream about one day becoming a ballerina, an astronaut, or other glamorous characters they see in books and on TV. I never had that when I was a kid. Adults also have dreams of conquering some personal goal - owning their own business, climbing Mount Everest, finding their soul mate. I never really had these sorts of dreams either.

I think my inability to have such lofty dreams comes down to the word itself. A dream sounds so foggy and far away that I just don't like the feeling it gives me of its being unattainable. I prefer to think of dreams as goals. If I were going to dream of owning my own business some day, I'd just set it as a goal and then get it done. Why call it a dream?

So then, did I have any goals growing up? No, didn't have any of those either. As I look back on my life, I'd have to say that for somebody who thinks she's pretty damn smart, I haven't been very creative in putting my intelligence to good use.

Questions From Blog Reader

A blog reader saw the two documentaries about me that I've posted on my blog. She/he had some follow-up questions which I thought were pretty interesting so here they are:

1) Every human fears death. Once they hear the word "cancer", they think there's no cure & death will eventually come. How did you actually react & feel when you first learned that you had cancer?

I was completely taken off guard because my doctor had said the lump was a clogged milk duct. When the surgeon said, "It looks like cancer," I told him I'd like to call my husband to see if he could come and join our meeting to discuss what to do about it. I didn't cry or get scared. I went into information-gathering mode. I didn't know anything about cancer at that point so I didn't even know whether I should be scared.

2) How did you actually overcome your emotions & fears about your illness?

I tackled the problem with knowledge. I got control of the situation by finding out as much as I could about my cancer and learning how best to treat it to give me maximum time alive. I didn't get very emotional, except when I thought about my kids growing up without a mother. I'm not sure I could say I've been very afraid, either. Yes, I'm afraid of the process of dying - the pain and feeling of suffocation when my liver and lungs start shutting down. And then there's the pain and sadness I'm going to put everyone through watching me waste away or worse, writhing in agony. But I'm not religious so I don't think I'm going to Dante's Hell or anything like that.

3) Is there anyone whom you can talk to for advice & encouragement?

My husband Tony and my friend Michelle come to mind, but collectively, most of my friends, family, and even complete strangers through this blog. I also talk to myself a lot (in my head).

4) What are the things that made you overcome the fear of Death?

I don't think I ever really had a fear of Death, just the actual process of dying. Maybe I should. I'll try to think about it more and cultivate a healthy, human fear of Death because I see that it's beginning to bug people that I'm not terrified of dying.

5) What is your Motto & Motivation in Life?

Motto? I need a motto? If I had to have a one-liner that I could call my motto, I'd say it's, "You're stronger and smarter than the average bear so ACT like it!" Motivation in life? To leave this world a better place than it was before I got here, even if it's just a teensy weensy bit, say, in the form of two beautiful kids who will go on to do their bit also. And then their kids do the same, and their kids, and so on and so on until the math works out and the good outweighs and swallows up the bad and we all live happily ever after or at least learn and grow a lot while trying. And if not with kids, with the people we come in contact with and rub off on each day.

6) What do you think is the most rewarding thing that you have achieved or done in this life so far?

Having kids and leaving them with something worthwhile, i.e., this blog and the people who say that I've helped give them strength and inspiration in their own struggle with cancer.

7) What do you think is the most miserable thing in life?

Inhumane behavior, e.g., people who kill in the name of their god, people who hurt children, people who hurt themselves out of self-pity, any behavior that makes me wonder whether human beings really are superior to animals.

Sorry, but there was one more question that I couldn't post because I didn't understand the question. Can you re-send it please?

Didn't Your Mother Teach You?!

A number of years ago, in pre-kid days, I was driving down a two-lane street when I noticed that my lane up ahead was blocked by an illegally parked truck. So I signaled to move into the lane to my right. To my surprise, the car on my right didn't slow down to let me in, it actually sped up to come alongside me so I couldn't get into that lane!

When we'd both reached the traffic light up ahead, I rolled down my window and asked the driver of that wayward car if he hadn't seen that I was trying to get into his lane because my lane was blocked by the truck. He said he had. I asked why he hadn't let me in and he asked, "Why should I?"

I was baffled. "Because it would have been the nice thing to do," I said.

His response? "Why should I be nice?"

This guy was in his early twenties, gel in his hair, slave to metrosexual fashion trends. Not that I'm suggesting that his interest in his physical appearance is reflective of his self-centered view of the world, but I am... His buddy in the passenger seat cringed upon hearing what his friend said to me.

All I could think to say back to him was, "Your mother would not be proud of you!"

I know. That sounds like something an old lady would say to some kid trampling all over her geraniums. But that's the first thing that crossed my mind - that somewhere, this young man's moral education had gone awry and it was either his mother's fault or worse, she'd done her best and still he turned out to be morally bankrupt.

As parents, we think about teaching our children manners, basic common courtesy, and right from wrong. Because I might not live to watch Toby and Josie grow up, I think about this sort of thing more than the average parent.

When Toby and Josie don't greet visitors properly, when they don't say "thank you" and "please", when they speak rudely to adults, I can just hear people thinking, "Didn't their mother teach them properly?!"

I even tell the kids that people will think that. I tell them that if they have bad manners or behave badly, people will think they had a bad mother. (This is the passive-aggressive guilt technique that Korean and Jewish parents are famous for.)

For some reason, lessons in manners and basic codes of behavior seem to be the province of mothers, not fathers. I didn't tell that twenty-something driver that his father would be appalled by his behavior. It was his mother I blamed.

Maybe Toby and Josie will be given a pass in this area of their lives. When they burp in public, when they let a door slam into the face of the person behind them instead of holding it open, when they walk into an elevator before the other passengers get off, when they don't use their signal lights in the car, when they don't let pedestrians have the right of way, when they treat shop clerks or waiters with disrespect, when they don't clear their own litter in public eating places... people will whisper to each other, "They don't know any better. You see, their mother died when they were very young." And people will nod their heads knowingly, with sympathy.

Grim Reaper Dream

I had a dream about the Grim Reaper last night. I should put it in context. Before bed, I saw a brief snippet of a TV show, "Dead Like Us", where Reapers go around collecting dead people's souls. It's a comic drama, rather than a serious scary show that the topic may imply.

In my dream, I saw a teenaged hoodlum across the street bothering somebody - a little old lady or somebody defenseless. He was wearing a black hood, jean jacket, blue/brown plaid shirt, too-big jeans (a la gansta fashion), and sneakers. I ran across the street and grabbed the urchin by the neck and raised him into the air - he was surprisingly light, weightless even.

As I did that, I could see inside his black, pointed hood into a dark void. There was no face in there. Then it hit me that I was dealing with the Grim Reaper. But I was still annoyed with the audacity of this gangster boy bothering a little old lady so I smacked him around anyway. Slap, slap, slap. He didn't respond, just floated up there as I held him up by the neck. I finally let him down and told him he could hang around as long as he didn't bother anyone else. And that was that.

Lessons In Listening

The other night, Josie needed help in the bathroom after Toby had gone to sleep. The two of us had to be quiet so we wouldn't wake up Toby (the bathroom is inside the kids' room). When Josie was finished, she started opening the door, letting out the light and the noise while I tried to tell her several times not to open the door. She just ignored me and opened the door anyway, which really annoyed me.

I told her to step back into the bathroom and asked her, quite irritated, why she'd done that. She looked completely puzzled and explained, "But Mommy, I didn't know what you were saying to me. The toilet flush was making a noise and the sink water was on and you were talking to me at the same time so I couldn't hear what you were saying." Then it occurred to me that she had a legitimate explanation, but here I'd gone and gotten all annoyed at her because I thought she was intentionally ignoring me.

Then I wondered... what if I hadn't given her a chance to explain herself? I would have just assumed she was being a brat and ignoring me. I wonder how many times a day we do this to our kids? We just assume we know what our kids are thinking, doing, or intending, so we just don't listen to them or give them a chance to explain themselves. I wonder how much we miss as a result?

I've noticed something that all parents do. We ask our kids a question, then don't listen to the answer. Or they talk to us, go off on long-winded explanations and we say absent-mindedly, "Oh? That's great! Uh-hum. Really? Right." Meanwhile, we don't make eye-contact with them or really listen to what they're telling us.

Sometimes, when our kids repeat the same thing over and over again, we get annoyed and yell at them, "Okay! I heard you already! Will you just give me a minute?!" The thing is, if you'd answered him or at least acknowledged in some way that you'd heard him, he wouldn't have said it over and over again until it got annoying.

I know we do this with adults as well, especially between spouses or among family, because we're used to being with each other and ignoring each other.

But with kids, this type of behavior is really baffling. What are we teaching them? How to be annoying to adults? How to be ignored? How to keep saying the same thing over and over again, each time louder than before?

One very fortunate side-effect of my cancer is that I've become a better listener - not because I've gone all Zen and reflective, but because the cancer in my lungs makes breathing difficult and I can't talk as much. So for once in my life, I listen more than I talk.

Now, I find I pay much more attention to my kids. Toby has recently discovered the art of monologue. He can go on and on about who-knows-what, whether somebody is listening or not. And when I stop and listen, really listen to him, I'm often rewarded with imaginative, funny stories and priceless peeks into his mind that I wouldn't have otherwise. From eavesdropping on his ramblings to himself, I've gotten to know a side of Toby I would have missed. To think... I would've missed this about him.