It’s kind of spooky how consistent the weather can be from year to year. Even with the effects of global warming, which are unmistakable in upstate New York, a day in December one year is eerily like the previous year. It’s almost enough to make you believe there really is a cosmic clockmaker whose spheres operate with unfailing precision. Almost. As I write this, it’s 39 degrees outside. The sky is a roiling ocean of gray-on-gray, and there is intermittent freezing rain that leaves tiny ice granules all over my parka. I mean, it looks exactly like this time last year, right down to the crunchy brine of snow on the sidewalk and the desiccated maple leaves blown up against the curb out front.
That sense of sameness tempts me to imagine the last 12 months were just a fucked-up dream brought on by too much Tito’s the evening before.
Last December 22nd was the day I drove to an Albany urologist’s office—in weather just like today’s—to learn I had “locally advanced” prostate cancer. The news wasn’t a huge surprise by that point. When my second PSA test registered an eye-popping 19.6 ng/ml, I started prowling the internet for risk calculators to gauge my likelihood of having cancer. Over and over again I got a nearly 60 percent probability. So, by the time my urologist delivered the news, I’d already lost confidence in my theory that I aggravated my prostate by riding horses.
How to Mark a Cancer-versary
It’s become a cliché that, when you receive some scary diagnosis, the doctor gives you a book with some dumbass title like “Cancer and You.” The book I received featured stock images of contemplative men on the cover and a sidebar with enticing questions like “What is castration-resistant prostate cancer and metastatic castration-resistant prostate cancer and how are they treated?” Looking at the book on the elevator, I wondered why someone—anyone—thought it was a good idea to refer to castration on the cover.
Along with the book, my doctor gave me a sheet of paper listing my clinical stage, PSA score, and Gleason number (which ranks how aggressive your cancer is on a scale of 1 to 10). Before that appointment, I was a fairly fit 56-year-old man with an unremarkable medical history. When I exited the building, I was a newly initiated cancer patient whose PSA score made the urologist’s forehead furrow whenever he spoke of it. Reading the doctor’s face, I found little comfort in his cheerful bromide that I had the “good cancer.”
I’m not given to regrets. I think they’re a waste of time. So it’s uncharacteristic of me to want a do-over for a whole year. But, honestly, I’d take it. Since that’s not an option, I think instead of how to mark such a weird life event as a cancer diagnosis. For me, it’s like flagging a stratum of earth in an archeological dig. That thin, dark layer sandwiched between two remarkably similar December days is the year of prostate cancer. Exposed as it is, it becomes a new fact of my accumulated history. It defined a year of my life and inevitably redefines how I view my future. But that’s pretty usual for cancer patients, I think. Riding the archeology metaphor a bit more, I like to think of myself as moving around that dig with a confident expectation that the next spade of dirt will unearth a rare artifact, some glittering jade effigy or carnelian intaglio. Seeing it that way, for me, makes that thin, dark layer below no less real, just a lot less relevant.
The story of my diagnosis and treatment are recounted in my book Midpoint: Manhood, Midlife, and Prostate Cancer, due out in May 2019 from Koehler Books.