Less than the Least

Greetings, and welcome to those who have found their way to this site.

I have no experience at blogging, so I’m not quite sure how to begin. But a bit of autobiography seems in order. Like David, I’m a law professor – I teach criminal law and criminal procedure at Harvard – and also an evangelical Christian. That puts us in a pretty small, and maybe pretty weird, demographic. I’m also a political junkie and a registered Republican, though I’ve cast as many Democratic votes as Republican ones. I’m interested in all those things – law and legal theory, crime and criminal justice, everything about American politics and political culture, the culture of evangelical Protestantism, and the intersections of various items on that list. David has a similarly broad set of interests – plus, he’s an uncommonly smart and interesting guy. Which is why blogging together seemed like a good idea.

I have one more pair of interests worth noting in this initial post. For the past eight years, I’ve lived with chronic pain in my back and right leg. The pain is constant now, and severe. Recently, another medical condition has joined that one: I have colon cancer – a piece of unpleasant news I learned about ten days ago. I’ll have surgery this week, probably followed by chemotherapy. These days, back and leg pain is joined by a lot of pain in my abdomen: sometimes, I think everything hurts. And I’m very, very tired.

I’m unbelievably tired these days, and I know I’ll feel more so after this week’s surgery. I’m tired from the drugs I take, tired from the pain in my back and leg, and now tired from the tumor inside me. The end of Isaiah 40 seems to speak to that weariness. The words are famous:

“Even youths grow tired and weary, and young men stumble and fall. But those who hope in the Lord will renew their strength. They will soar on wings like eagles; they will run and not grow weary, they will walk and not be faint.”

I’ve heard and read those words many times. Roughly translated, they seem to say: when we fall, God picks us up. Sometimes it works that way. But often, I find that when I fall, I stay down – or fall farther. Life is not always a happy picture of obstacles overcome, difficulties surmounted. Rotten things, like cancer and chronic pain, happen. Healing happens too, but not always. There are no guarantees.

Physical pain hurts, ugly things look bad, nasty smells smell nasty. What do these basic realities have to do with one another?

I’m pretty sure the conventional response is: not much. Ugliness is an aesthetic judgment, and aesthetics seem somehow not quite real – a kind of ethereal sensibility that one cannot possess absent a measure of training and refinement. Pain, on the other hand, is reality itself: as hard as the ground underneath one’s feet. It is the reality into which all other realities collapse. The more you hurt, the more you do nothing BUT hurt. No training is needed to absorb that lesson.

My surgery happened about ten days ago; I’ve been home from the hospital for a week. The surgery went well, as these things go: the tumor was sizeable but they apparently got all of it, which is good news. Cancer has spread to a few lymph nodes, but fewer than the docs expected. I’m to start chemo, and possibly radiation, soon.

I was hoping to do a fair bit of blogging during this time, but that may be harder than I had imagined: there are good days and bad days, and on the latter, reading and writing just aren’t possible. I’ll do what I can.

I’m trying to feel that eagle soaring . . .

I’ve spent the month of March, so far, recuperating from surgery for colon cancer. You read a lot when you’re getting over surgery—and, if you’re like me, you watch a lot of “Law and Order” reruns (preferably, any episode that includes the late Jerry Orbach)—and one of the subjects I’ve been reading about is, no surprise, cancer.

Sometimes, the reading is a help. People who have been down this road know things about it that I don’t, and some of them are things I need to know. But the accounts of cancer treatment I’ve read have some problems. One in particular bothers me.

I’ve spent the month of March, so far, recuperating from surgery for colon cancer. You read a lot when you’re getting over surgery—and, if you’re like me, you watch a lot of “Law and Order” reruns (preferably, any episode that includes the late Jerry Orbach)—and one of the subjects I’ve been reading about is, no surprise, cancer.

Sometimes, the reading is a help. People who have been down this road know things about it that I don’t, and some of them are things I need to know. But the accounts of cancer treatment I’ve read have some problems. One in particular bothers me.

I’ve spent a fair bit of time around hospitals over the years: two major abdominal surgeries, three lower-back fusions, and more injections and films and tests of various sorts than I can count. The Boston-area hospital I’ve come to know best is Massachusetts General, where my last three surgeries were done.

This past week, I paid my first visit to a cancer treatment center: the Yawkey Center, named for longtime Red Sox owners Tom and Jean Yawkey, whose charitable foundation helped build it. The difference between that center and the hospital that sits next door to it is mind-blowing. Mass General embodies bureaucracy of the coldest sort. Yawkey oozes warmth. The waiting room—where cancer patients sit while waiting to have blood drawn or to see their oncologists—faces one of the best views of Boston I’ve ever seen. You can’t look at that view and avoid smiling. Notice: that smile-inducing vista belongs not to doctors in their offices, but to cancer patients.

My cancer has been promoted: I’m officially in stage 4. My doctors have found two cancerous nodules—a euphemism for “small tumors”—one on each of my lungs. I started chemo this week. Next week, I’ll see a thoracic surgeon who will, sometime this summer, cut those tumors out. Needless to say, this isn’t good news—though, thanks to medical advances (especially, thanks to those evil drug companies that politicians regularly attack), it isn’t disastrous news either. We’ll see what the future brings.

I don’t have any previous experience with this sort of thing, but judging from what I hear and read, I’m supposed to be asking why all this is happening, and why it’s happening to me. Honestly, those questions are about the farthest thing from my mind.

Thanks to some of my cancer survivor friends, I recently discovered that Wikipedia has an entry for “Chemo brain.” (The link is here.) They call it “Post-chemotherapy cognitive impairment,” but I think the simpler label works better.) So far as I can tell, it’s totally true: these drugs seem to have roughly the same effect on mental acuity as repeated viewings of “Legally Blonde.” I can feel the I.Q. points departing, perhaps never to return. And I didn’t have that many to spare.

I know that a lot of interesting work is being done these days on links between mind and body. I’d love to understand those links better. One thing is clear: when your body takes hard shots, your mind suffers. A pain researcher once told me that chronic pain patients’ minds age much faster than the population at large; fighting off the pain uses up mental energy, and not all of that energy gets replaced. So too with fighting off cancer cells, I suspect. Thankfully, I’m not a mathematician—I’d already be far too dumb to do the job. Legal academics is a more forgiving line of work, and these days, forgiving lines of work sound pretty good to me.

“Live strong” is a common slogan among cancer patients. I think I understand the slogan’s appeal, and I admire the spirit that lies behind it. But it doesn’t fit my experience, and I suspect I’m not alone.

Reduced life expectancy aside, the chief consequence of stage 4 cancers—even more, the chief consequence of their treatment—is weakness, not strength. Cancer and chemotherapy, taken together, are exhausting. Walking up a flight of stairs feels to me like running a couple of miles would feel to a typical out-of-shape 50-year-old, which is what I would be if I were healthy. All mental exercises are several times harder than they used to be. Concentrating takes real effort, and most of the time, I can’t pull it off—I have to read things twice (at least) in order to understand them once. My mind is two steps behind whatever conversation I’m in; I have to scramble to keep up. I feel half dead, as though a large fraction of whatever I was is gone, never to return.

In short, I can’t live strong, because there isn’t much strength left in me. But I can live weak.