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February 28, 2008

Welcome

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.

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On Being Weary-- Stuntz

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.

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March 2, 2008

Pain and Ugliness-- Stuntz

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.

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March 10, 2008

My Condition--Stuntz

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 . . .

March 22, 2008

Battling Cancer--Stuntz

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.

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March 28, 2008

Hospitals and Cancer Treatment Centers--Stuntz

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.

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April 3, 2008

More Cancer--Stuntz

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.

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April 18, 2008

Chemo Brain--Stuntz

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.

May 10, 2008

Living Weak--Stuntz

“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.

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June 5, 2008

Living and Surviving--Stuntz

Last week, I got some very good news—but it didn’t feel good at all. This week’s news was medically neutral, as these things are usually judged. But it felt incredibly sweet.

That sounds strange, so let me try to explain. Last week, I learned that the past two months of chemotherapy has been working: the latest round of films showed that two tumors on my lungs have shrunk slightly, and that no new bits of cancer are visible—not on my liver (which is where late-stage colon cancer tends to migrate), and not on my lungs. That doesn’t mean I’m cancer-free save for those two lung tumors. As I understand it, the odds remain high that there are small bits of cancer out there, including at least some on my lungs. But the films suggest that my chemo regimen can either kill those incipient tumors or stop them from growing. Which means my life expectancy just got longer by at least a year, and maybe more.

Like I said, it’s very good news. What’s not to like about a longer life expectancy when faced with a killing disease?

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June 30, 2008

Another Surgery--Stuntz

Four months ago, on February 27, doctors removed a large tumor from my colon, along with a fair chunk of the surrounding abdominal tissue. The tumor had broken out, but they didn’t know how far the cancer had spread. Last Friday, June 27, four months to the day afterward—a different set of doctors took out two smaller tumors, one on each lung. The doctors also took out two even smaller growths that were too small to show up on films. But these other growths turn out to have been benign. So far as anyone now knows, my lungs are cancer-free.

It’s possible the news will turn out to be less positive. Once it breaks free of the organ where it finds its first home, cancer is like the proverbial bad penny: it tends to keep popping up. Eventually, metastasized cancers like mine usually kill their patients. Eventually, but not always—and not always soon.

That’s why cancer patients think differently about time than most other people.

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July 3, 2008

Bill's Fiftieth

We won’t ordinarily celebrate events like birthdays on this blog, but today’s is special enough to warrant an exception: Bill has just turned 50. It’s hard to believe he is fifty years old now, but it is also hard to believe that a scholar who has contributed so much for so long is only fifty. My prayer, to use the terms of Bill’s remarkable reflections on time in his recent blog posts, is that this year will bring not just survival, but a great deal of life.

Happy Birthday, Bill.

July 13, 2008

Tony Snow--Stuntz

I never met Tony Snow, the onetime White House press secretary who died of metastatic colon cancer yesterday. But I wept when I heard the news. Much to my surprise, Snow emailed me a few months ago after he heard about my disease—we must have a mutual friend or two, though there can’t be many: I’m not well connected in either media or political circles. He wrote to encourage me, and to offer some practical advice. The best advice was this: keep living. Cancer and its treatment can occupy every waking moment (while drastically increasing the number of sleeping moments). Don’t let it, Snow said. Live and work and, most of all, love—as much as you can, as often as you can. It was and is terrific advice. And it was an extraordinarily kind thing, the act of an uncommonly good and decent man—coming from one who, even then, was fighting the last stages of this awful disease. My heart and my prayers are with his family. May God bless each and every one of them in this hard time.

August 3, 2008

Living In Between--Stuntz

Since my films are now clear, my oncologist tells me that I have a good shot at living for what seems like a long time: my five-year survival odds are in the 25-30% range, if I understand the data correctly. Those odds are much higher than anyone with metastatic colon cancer has any right to expect—for which I’m very grateful. It may sound strange, but I’m a very lucky guy, as my cancer patient friends know well.

The news isn’t all good. If I’m not in that happy 25-30%, my life expectancy is two years, maybe a little less. Apparently, the mortality curve for someone in my situation is not a bell curve with a long tail, as I had assumed. Instead, the curve has two humps: one that begins in about a year and a half (again, if I understand the relevant data), and another one several years later. Odds are, cancer will either get me soon, or not for a long time.

In the meantime, I seem to be nearing the end of the treatment road, at least until the cancer pops up again. Chemo begins in a little over two weeks, and will last for a few months. Then, I wait. If and when the cancer comes back—probably in my lungs, since it’s already been there—chances are, it won’t be treatable.

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August 28, 2008

Chemo Again--Stuntz

Last week, my latest and I hope last round of chemo began; unless things change, the plan is to keep going til mid-December and then quit for good.  I feel lousy:  low-grade nausea is a constant companion, and sometimes it isn't low-grade.  One of the drugs gives me a swollen and sore mouth, which makes eating, drinking, and talking painful.  (No doubt my speech has often pained my students.  Maybe this is payback.)  And, of course, there is the onset of Chemo Brain, just when classes are about to begin.  (What was I talking about again?)

 

One day, I suspect we will see today's chemotherapy as akin to leeches and bloodletting for patients thought to have "bad humours" in their blood:  earlier versions of the kind of medicine that kills the disease by killing the patient.  Of course, the comparison isn't quite fair, and it seems ungrateful on my part to make it.  These treatments are not killing me--on the contrary, they may be keeping me alive.  I should be thankful, and I am, for the skilled and decent men and women who supervise my drug regimen.  Whatever life I have left, I owe to their competence and commitment.  I can't say enough good things about them.  Still, it's a strange enterprise:  progress happens, but it always feels like regress.

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Lake House--Stuntz

Thanks to the kindness of some local friends, Ruth and I have spent most of this week at a lake house in New Hampshire.  It's a remarkable place.  Staggeringly lovely and (much to my surprise) nearly deserted:  I guess the traffic returns on weekends.  Today was still; the lake looked glassy save for the tiny ripples moving along its surface.  Sitting on an old wooden dock, all I could hear was the low buzz of insects, a few birds, and the sound of barely-moving water lapping at the dock.

 

To me, such places offer a kind of magic.  Their near-silence sings to my soul:  a soft love song, sweet and sad and achingly beautiful.  The scene seems at once alive and at rest, and I feel as though I belonged to it.  I usually think of myself as having been made to do things:  raise a family, teach, write.  But I wonder sometimes whether, instead, we might be made for places.  If so, I was made for someplace like this.

 

Though I love that world, going home to the world of cities and cell phones and reliable internet access will be hard.  But then, I'm not sure whether I'm going home or leaving it.  Beauty can confuse, even as it captivates.

September 19, 2008

Illness, Grace, and Friendship--Stuntz

Not long ago, I read something by Roger Ebert, a skilled and insightful movie critic who has battled thyroid cancer and related conditions for a long time now, in which Ebert said roughly this:  Cancer patients are widely seen as courageous.  Presumably some are, but for most of us, the virtues others ascribe to us are not merited.  The truth is, patients who live with advanced stage cancers have little choice in what we face; for most of us, life consists of putting one foot in front of the other, doing what you have to do and along the way, preserving and treasuring whatever small slices of normality you can.  Like Ebert, I don't see much virtue in that.  I've always been more cowardly than courageous, and I don't think my illness has changed that state of affairs.  If anything, the opposite:  I had several extended hospitalizations as a kid, and those seemed easier to me than the ones I've had recently.

 

Much to my surprise, what I've found instead is that my illness has revealed the virtues of my friends and my family.  I know that spouses and children, parents and siblings are supposed to and usually do love one another.  Still, I've gotten far more than my share of that love over the past seven months, even (maybe especially) on the many days when I've been irritable and worse.  More surprising still, those months have seen a host of friends, including more than a few I didn't know I had, coming out of the woodwork--offering blessing and support, assistance and encouragement, precisely as those things have been needed, all without my lifting a finger to ask for them.

 

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October 31, 2008

Good News on the Cancer Front--Stuntz

On Wednesday of this week, I heard that the latest round of films were clean--no tumors in my lungs or in my abdomen. Lungs and livers are the places advanced-stage colon cancer likes best. The fact that they appear to be cancer-free now doesn't mean I'm cured, not by a long shot. But it does raise the odds, if only by a little, that I'll be around for awhile longer. For me, that's very good news.

Not long ago, a wise friend told me that the key to navigating cancer treatment is not to get too high when the news is good, and not to get too low when it's bad. That's good advice: there are many twists and turns in this road, enough so that good or bad news is likely to be followed, sometime, by its opposite. Even so, I can't help experiencing a measure of joy about this latest development. Maybe--just maybe--I'll live to hold a grandchild, or see my sons, ages 20 and 18, graduate from college. If not, that's OK; I don't feel cheated: many, many people in this sad world suffer much worse and deserve much better than I. Good medical news is no moral entitlement--not something I'm supposed to have. The feeling is more akin to a child's wonder at the packages under the tree on Christmas morning. I remember that feeling well; it seemed as though my whole body smiled. It feels that way now. Even if there are no more such presents, thanks be to God for this one.

November 20, 2008

Chemo's End, Cancer's Closet--Stuntz

On Wednesday of this week, I had my last chemo session--at least for awhile and maybe for good.  I'm not quite done--I'll carry around a pump with a drug called (believe it or not) 5-FU until tomorrow afternoon.  Cancer treatment isn't usually funny, but that name cracks me up.  Anyway, once I'm unhooked, I'll be finished with chemo until the cancer returns, and perhaps even then.  The odds that I'll survive another five years or longer are about 30% now, which is very good indeed for a patient with stage 4 gastrointestinal cancer.  Even if I'm on the wrong side of those odds, my chances of living at least another couple of years are significantly better than they were several months ago.  All of which is very good news, for which I'm very grateful.  God is good, even--especially--in hard times.

That good news means my life is about to change.  Save for three weeks in June, the past nine months have been spent having surgery, recovering from surgery, or having weekly chemo sessions (plus a couple of days of the amusingly named drug every other week).  Those chemo sessions and the days between them have been rough--either because that's the nature of the relevant drugs or because I'm unusually susceptible to the side effects.  Maybe a little of both.  Nausea and fatigue have been more or less constant.  Along the way, I've suffered skin rashes, mouth pain, some bleeding in fingers and toes, various other irritating conditions that are too gross to describe, and--worst of all--increasing stupidity.  I so, so look forward to recovering the more-or-less normal use of my body, not to mention a functional brain.

It's hardly surprising that the prospect of finishing cancer treatment--again, at least for the time being--is very pleasant indeed; I can't type the phrase without smiling.  What surprises me is that, in some ways, the prospect is also a little sad.

Continue reading "Chemo's End, Cancer's Closet--Stuntz" »

January 3, 2009

Chemo Aftermath--Stuntz

Apologies for the long silence:  my chemo ended just before Thanksgiving, but the six weeks since them has been rougher than I'd expected:  I'm still pretty tired and a little queasy all the time, and have been struggling to fight off an infection.  All of which has left me feeling a little down.  It's as if something inside me didn't permit depression to take hold in the midst of chemo and cancer surgeries.  Now that I have a little breathing space, the story is different.

 

Dealing with cancer is a little like raising kids.  Parents figure out how to handle a two-year-old at about the time the child turns four--at least I did; I was always behind the curve.  So too here.  By the time my last round of chemo was ending, I knew how to do chemo.  I haven't yet gotten the hang of this stage of the process, when I'm trying to put one foot in front of the other with an hourglass staring at me.  But plenty of people have made this adjustment (and much harder ones) before, and I'm sure I will do so too.

 

February 9, 2009

Testimony--Stuntz

 My spouse and I are in the process of joining a Boston church; the church requires that would-be members give their testimony. Because my memory is lousy these days, I wrote mine out; it’s pasted below with a few minor edits. Some of this material, though not all of it, will be familiar to anyone who read this blog last spring. Here it is:

     I would have said I was a believer when I was a teenager, but I’m not sure that was really true. I now believe I became a Christian in my mid-20s—a few years after Ruth and I got married, while I was in law school and shortly afterward. Two things triggered my conversion. First, I started reading C.S. Lewis, and it blew me away. Before that, I never saw how unbelievably beautiful our faith is—like a love song that makes you weep every time you hear it. More than I believe in any set of abstract propositions, I believe in that love song. Abstract truth is often beyond our ability to grasp. (If you doubt that, spend some time trying to understand quantum mechanics.) But we were made to see beauty. Reading C.S. Lewis taught me that.

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February 25, 2009

More Films--Stuntz

 Every few months, the docs check my lungs and liver and assorted other places to see whether the cancer has returned. Today was my day to be filmed. Film days are usually easy, though sometimes unpleasant: I spent the minutes before heading to the radiology department ralphing in the parking lot. (I’ve always loved the verb “to ralph.” It’s a classic onomatopoeia. I wonder what the analogous term is in other languages—does it have the same sound? Weird the things I think about . . .)

 
These days, what strikes me as interesting about these periodic films is their utter routine-ness. A year ago, I’d have spent the time between the taking of the films and hearing my oncologist’s report worrying about the results. Now, I barely think about the issue. Not because I’m an optimist—I know well that, sometime soon, the news will likely be bad. The sensibility is a bit like living in a war zone, at least as I imagine that experience: You know the bombs will fall tonight, and you know that, while the odds are in your favor on any given night, if the bombing lasts long enough you’re likely to get hit. Nothing to be done about it, so you go about your business. Is this what it was like in London during the Blitz? I wonder.

March 9, 2009

More Good Cancer News--Stuntz

I got the results of my latest set of films a few days ago—no visible cancer in my lungs or abdomen: the places where it is likeliest to show up. Happy news indeed. As my oncologist puts it, each clean set of films is “eating up risk”: the next eighteen months are the time when cancer is most likely to reappear. (When it does reappear, it’s likely to stick.) That scenario is still probable, but it’s less probable than it was. 

I’m still experiencing what I’d call chemo side effects if I hadn’t been off chemo for three months now: I remain more tired and queasy than I should be. Plus, my back and right leg hurt as much as they ever have—meaning, they hurt a lot and they hurt all the time. Even so, this latest news is very good news indeed. Whenever the good times end, I will still be grateful for this time.
 
 

March 23, 2009

Reforming the Health Care System--Stuntz

It’s often claimed that other Western nations achieve as good or better outcomes from their nationalized health care systems as Americans achieve with our strange mix of private and government-funded health insurance—and at far less cost. Assuming that claim is true, it might be true for a reason policymakers haven’t considered. Right now, a hugely disproportionate share of the world’s medical innovation happens at the high end of America’s health care market. People like me benefit hugely from that innovation: I’m a well-insured cancer patient living near Boston, which may have the world’s highest per capita concentration of medical talent outside Rochester, Minnesota. 

But we’re not the only ones who benefit. The most successful of those medical innovations soon filter down to the rest of America’s unsystematic health care system, and then to other parts of the rich world. Those nationalized health care systems in Canada and Western Europe achieve such good outcomes partly by relying on American medical research, much of which is funded by that high-end medical market.
 
Why does any of this matter? It matters because we are about to take a large step toward nationalizing our own health care system. The funding has to come from somewhere, and the most natural “somewhere” is the money that now flows from companies that insure patients like me to institutions like Massachusetts General Hospital, the Mayo Clinic, or Sloan-Kettering. One must tap the money at the top of the market in order to have enough to “spread the wealth around.”
 
But that ignores the character of the medical market we have now. The best-off patients don’t get better care than everyone else; they get the best care sooner than everyone else. Take away the high end of America’s medical market, and a large fraction of the life-saving innovation that market produces may disappear. That will hurt all of us—in the United States and abroad.
 
Let me be clear: I don’t believe I have any moral entitlement to the extremely high-quality (and extremely expensive) health care I’ve gotten. I’d happily sign on to a health care system that distributed its benefits more equitably, even if I lose out in such a system. I’m less willing to go along with a system that doesn’t protect this most innovative sector of America’s economy. I hope some of the key players in the Obama Administration share that concern. I fear they don’t.
 

March 24, 2009

Depopulation--Stuntz

This article made me sad. The subject is the coming depopulation of much of the world. Here’s the key graph:

For the majority of the world's inhabitants who no longer live on farms or rely on home production, children are no longer an economic asset but an avoidable liability. At the same time, the spread of global media exposes people in even the remotest corners of the planet to glamorous lifestyles that are inconsistent with the sacrifices necessary to raise large families. In Brazil, birthrates dropped sequentially province by province as broadcast television became available.
 
I suspect another cause: depopulation happens when religious faith disappears. If the point of a couple’s life is to maximize their own comfort, having any children is hard to justify. Raising kids costs money and, even more, time. It saps both energy and confidence—I never knew what a total screw-up I am until Ruth and I had children. Often, it’s painful: there is nothing so agonizing as watching your child suffer. And children expose parents’ worst flaws, like a mirror that reflects only warts and unkempt hair. Why go through all of that—not once, but several times—if you don’t have to?
 
But if life’s goal is larger than maximizing my welfare, if my job is to leave the world better for my presence in it, having children is much the best means of reaching that goal. I have far more confidence in my kids’ ability to make their corner of the world better than in my own. Most parents I know would say the same. And the point extends beyond any utilitarian calculus. Those of us who believe in a good God who made human beings in His image also believe that we honor the family resemblance when we raise families. Christians believe God’s life and creativity could not be contained in a single divine Person. As the Father begot the Son, as the Son left the Spirit to guide believers, so should we do some begetting of our own.
 
Last but not least, raising kids is incomparably the greatest of life’s joys. Even in purely hedonic terms, I wouldn’t trade it for a lifetime of expensive vacations. The great irony of the contemporary West is that, in their ceaseless pursuit of pleasure, far too many citizens of the nations entrusted with Western civilization are missing the greatest pleasure of all. Civilization itself may be that error’s biggest casualty.
 

March 30, 2009

A Pain Poem--Stuntz

Recently, I stumbled across this wonderful and sad poem by Edna St. Vincent Millay. It’s the best description I’ve ever read or heard of living with chronic pain:

 
And must I then, indeed, Pain, live with you
All through my life? Sharing my fire, my bed,
Sharing — oh, worst of all things! — the same head? —
And, when I feed myself, feeding you, too?
So be it, then, if what seems true, is true:
Let us to dinner, comrade, and be fed:
I cannot die till you yourself are dead,
And, with you living, I can live life through.
Yet have you done me harm, ungracious guest,
Spying upon my ardent offices
With frosty look; robbing my nights of rest;
And making harder things I did with ease.
You will die with me: but I shall, at best,
Forgive you with restraint, for deeds like these.
 
Pain and disease are like the walls of a prison cell; life in their midst is about breaking free, “liv[ing] life through” those walls. And yet pain is no mere physical boundary; it seems to have intelligence and personality: a “comrade” who (not that) spies on my activities “with frosty look.” It goes where I go and stays when I stay.
 
David and I work in an analytic business. Our professional bias is to see truth as a matter of logic and measurable empirics. But life is not all prose, and truth is not so readily found in philosophy texts and law books. Some things are deeper and richer than our analytic categories.

April 25, 2009

Working--Stuntz

The past few months have been discouraging. Thanks to pain, nausea, and fatigue—the first two are worse now than during chemo; the third is almost as bad—I’ve done a lousy job of teaching this semester. I’ve managed to do a little writing along the way, but only a little: much less than an ordinary semester’s work product.  Bad teaching and not much writing are not what I was hired to do. Frustration and guilt are constant companions. 

I wonder sometimes what it feels like to deal with cancer and chronic pain without a job. On the one hand, it would be a great gift not to feel that omnipresent guilt about badly taught classes and unproductive months. On the other hand, were work absent, pain and disease would fill my mind; nothing would be left to elbow them aside. I can think of few worse hells than that.
 
Which makes me wonder at this fact: the large majority of chemo patients I’ve seen at Yawkey (the Boston cancer center where I go) are well past retirement age. What must it be like to live with this disease and—just as bad—to live with the treatments without a job to occupy one’s mind? I shudder at the question. It sounds strange, but I’m thankful that this disease has caught me while I’m still working. The next thought is less odd: As badly as I do my job these days, I’m more thankful for it than I have words to express.

April 26, 2009

Signs-Stuntz

Cancer is more pickpocket than robber: it catches you unawares; you find out about it after your wallet is gone. Most of the time, anyway. 

But not all the time. My cancer was symptomatic before I was diagnosed in February of last year. The strange abdominal pain and my internist’s obvious concern after my annual physical left me unsurprised when the diagnosis came. Maybe it’s my customary pessimism at work, but I feel the same way now. Five months after chemo ended, I’m queasy all the time and nauseous much of the time, and I have a nonstop, low-grade headache that doesn’t always stay low-grade. The last few days, I’ve started to experience dizziness; I’m having trouble reading. My docs seem nervous: these could be signs that my cancer has spread to my brain—one of the places colon cancer likes to call home. Needless to say, that would be bad news. Another, less awful explanation is also plausible. These symptoms could be the effects of drug interactions; I’ve taken so many different pills that no one can say what the various combinations might do to me. My medical situation might be about to take a decided turn for the worse. Or, not so much. Either way, I’ll know soon.
 
Soon enough, by my lights. An old saying gets it about right: good news will keep, and bad news will find you. Part of me wants to know what the near future holds. Another part wants to hold onto my ignorance awhile longer—after all, ignorance is the only state I can freely choose. Choosing it now, if only for a week or two, feels empowering.
 

May 7, 2009

More Good Cancer News--Stuntz

I was more than a little nervous about the results of my recent brain MRI. I needn’t have been: the films were clear; no detectable cancer. (Insert sigh of relief here.) As a family member put it, “they took pictures of your brain and found nothing there.” . . . 

The films were obviously good news. At the same time, they also frustrate me: I have a nonstop headache, my right leg hurts more than it ever has, and I’m at least a little nauseous all the time—often more than a little. The headache I can deal with. Back pain, sciatica, and I are old friends; much as I hate it, I can handle that pain too. I’m good at pain. Nausea is another matter. It wears me down, interferes with work and with family life. Worse, it mystifies my docs, which means it won’t disappear anytime soon.
 
I’m pleased and relieved to know that my life won’t be ending as soon as I expected. And I well understand that the last portion of that life probably won’t be pretty: cancer deaths are a nasty business. All of which is OK. But I had hoped to have some time when I felt like I did before cancer entered my life—like I felt when my only health problem was chronic pain in my back and right leg. (“Only” doesn’t really fit in that sentence.) I haven’t seen that time yet. I hope it’s out there somewhere.
 

May 13, 2009

Spring in Boston--Stuntz

Before moving to New England nine years ago, a couple of friends told me that T.S. Eliot must have lived here when he wrote: “April is the cruelest month.” Winter seems to last forever—and then, bang! Summer comes. Spring pretty much doesn’t happen. Or so the conventional wisdom holds.

 It isn’t so. This time of year, you get lots of sunny days in the 60s, sometimes with a late shower thrown in. Trees are flush and dogwoods bloom; walking around my neighborhood, I can’t help smiling.  I’ll never understand why Bostonians are so fond of griping about the climate. . . .
 

June 5, 2009

Hospitals--Stuntz

Thanks mostly to medical business, I’ve been out of touch for awhile. I was hospitalized for various tests and procedures nearly all of last week (no large problems, thank God), and save for a brief appearance at the law school’s graduation ceremony – I love graduations: everyone is so unremittingly happy – have spent this week recuperating. 

Last week reminded me just how much attention patients in reasonably well-run hospitals receive. It’s remarkable; I saw a half-dozen doctors and another half-dozen nurses on a regular basis. Nighttime excepted, I rarely went as long as ninety minutes without at least one of them dropping by. Of course, I’m more advantaged than most patients. But this isn’t just a matter of class or status. My roommate, an alcoholic who appeared less than fully in touch with reality, had almost as much doctor attention and more nursing care than I had. All of which is a reminder that health care is a strange business: in the end, a large fraction of what sellers sell is human relationship. When done well, those relationships are a tonic. But it’s hard to see how one can both do them well and do them more cheaply – the twin goals of any plausible health care reform process. Plainly, the system needs reforming. Equally plainly, reform will come at a price. I hope it’s not too steep for patients like my hospital roommate, who need all the care they can get.

July 15, 2009

Sotomayer and the Cost of Success--Stuntz

A couple days ago, David Brooks had a wise and interesting column on Sotomayor and the price of professional success. (Link: here). Plainly, Sotomayor has paid a price for her achievements—according to Brooks, her marriage appears to have been a casualty of her work habits. Equally plainly, the point applies to a great many lines of work, not just to the legal profession. 

This is the aspect of my job and of legal jobs more generally that has most surprised me over the years. When I started in law teaching in 1986, the universal expectation was that workloads would diminish, that workplaces would grow more family-friendly as women populated the higher reaches of the professions in large numbers. Instead, Sotomayor’s experience increasingly has become the norm. High-end professional jobs have grown LESS family-friendly, as men and women alike sacrificed their marriages and relationships with their kids in order to put in the hours needed for success. My job seemed leisurely in the 1980s; by the beginning of this decade, most of my colleagues were routinely working evenings and weekends, as I was. When I was a kid, I remember jokes about doctors playing golf on Wednesdays. You don’t hear those jokes anymore; nearly all the doctors I know work very hard indeed. Again when I was young, the phrase “bankers’ hours” meant something akin to a 30-hour work week. No bankers work such soft hours today—nor did they do so before last fall’s crash. The list goes on and on.
 
I’m not griping here: I love my job; working long hours has often been a pleasure. Still, an awful lot of my friends work too hard, as I did before I got sick and was forced to ease up a bit. Why is that? I wish I knew. Is it a good thing? On balance, I think not. Will it remain so after we come out of the current recession? Stay tuned.
 
 

August 7, 2009

Still More Cancer, and Hope--Stuntz

Last week, my oncologist told me the results of the latest set of films: I appear to have a cluster of four small tumors on the left side of my abdomen, and one slightly larger tumor on my liver. My cancer is back, and in two places: a bad sign. I’ve started chemo again, and am feeling the usual symptoms, including constant queasiness and others too gross to describe in a family blog. My prognosis isn’t clear, but at this point, the range of plausible outcomes—see how easy it is to talk about the timing of one’s death?—runs from bad to worse. Still, sometimes improbable things happen; the disease itself is example enough of that phenomenon. Maybe my chemo will shrink these tumors, and buy me some time. I hope so, though I don’t assume so—and I try not to think too hard about the “hope” part of that sentence.

That last clause may sound strange, but then hope is a strange commodity. I have heard from more people than I can count that, above all else, the thing I must do (channeling my inner Jesse Jackson here) is to keep hope alive. Don’t give up hope. Don’t quit: battle your cancer as long and as hard as you can, believe that you can and will beat it. Keep hoping and the victory can be yours. 

Only it usually doesn’t work that way. My cancer is not subject to my will—nor to my doctors’, for that matter. Even if optimism is correlated with longer life (and there is some evidence for that proposition), the idea that hope produces the object hoped for remains false for most of us, most of the time. My cancer will do what it chooses—it seems to me an intelligent but demonic force—or what God chooses, not what I choose. My sovereignty doesn’t extend that far.
 
Which is OK by me. “Keep hope alive” amounts to the belief that I can control the outcomes in my life. Think about that for a moment, and you’ll see that it’s a terrible responsibility. I don’t want it. Much better to say: Forces beyond my control usually dictate my life’s circumstances, good and bad (and in my life to date there has been far more good than bad: few in this sad world have less reason for bitterness than I do). The most I can do is decide how to behave in the midst of them. That’s more than enough. So I’ll do my best to do my job, to care for my family, and to be faithful to my God. That too is more than enough. I prefer to place my hope in more secure things than my own very limited power.
 
 

October 6, 2009

Stuntz on Suffering

Bill had an article called "Three Gifts for Hard Times" in the August issue of Christianity Today, which I suspect will be of particular interest to those who have followed his posts on his cancer treatment.  I just noticed that the article is now available electronically here

October 21, 2009

Health News, and the Cost of Cancer Treatment--Stuntz

I haven’t posted for far too long; sorry about that. I’ve been hunkered down, trying to manage chemo—which is harder this time around than it was last year—and also trying to make some progress on a book I’m writing.

So, a quick update: When I last posted, the docs had found a cluster of tumors in my abdomen, plus one tumor on my liver. I started chemo immediately. Three weeks ago, I received news of my latest set of films: the tumors haven’t shrunk, but they haven’t grown either. That’s good news—though, as always in Cancer World, news is double-edged: it means I’ll be on chemo for at least several months longer. When (I’m past the stage where it’s appropriate to say “if”) the tumors resume growing, the docs will try a modified chemo regimen. Whenever that fails, we will look either at clinical trials or palliative care.
 
Those films also turned up a blood clot in one of my lungs, which the doctors found worrisome. I’m giving myself daily injections of a blood thinner, a small piece of unpleasantness on top of cancer treatment.
 
As Americans debate reform of the health care system, I increasingly wonder at the cost of my own medical care. At this point, chemo can extend my life only modestly; there is only a slight chance I will live more than eighteen months. Less is more likely.  The tradeoff seems worth it to me, for now: I want to be around to pay more of our youngest child’s college tuition, so that Ruth need not pay those bills out of life insurance money she may need for herself. I’d also like to finish my book, and spend more time with family and friends. But while those desires are perfectly legitimate, it is also perfectly legitimate for others—my colleagues whose insurance premiums pay for my medical care or the taxpayers who would do so under a government-funded insurance plan—to conclude that my preferences do not merit the huge costs required to (possibly) extend my life a few months. How best to negotiate that gap between my preferences and the public interest, not just for me but for the many patients in circumstances like mine, is a mystery to me. But I doubt we will ever get control of health care costs if preferences like mine continue to govern in cases like mine. Which makes me wonder whether I have a moral obligation to cease chemo sometime in the near future, and let my cancer take its natural course. Not a pleasant thought, but not a foolish one either. At least, so it seems to me.
 

December 11, 2009

Silence--Stuntz

Apologies for the long silence. Chemo brain has taken hold of me, and writing of all sorts has become a good deal more difficult than it was. I’ve never found writing easy, but I’ve always been able to do it. These days, I sometimes feel as though I’ve forgotten how. (What are all those letter keys on my laptop for?) That makes work on the crime-and-criminal-justice book I’m writing go more slowly than I’d hoped; recently, that has absorbed all my too-limited writing energy. I’ll try to do better in the future.

 
 

Cancer News--Stuntz

This past week, I heard the results of the latest round of films: none of my tumors has grown in the past couple of months, and the one on my liver appears to be slightly smaller than it was. This is very good news, about as good as one can get at my stage of cancer and cancer treatment. For which I’m very thankful. Enough italicized verys.

Silver linings usually come with clouds attached, and in this instance the nature of the cloud is, well, not at all cloudy: I have to do more chemo. The basic drill for most cancers that have metastasized in multiple places (three in my case), multiple times (twice so far) is simple: you do chemo as long as it holds the stuff off, shrinks it, or keeps it from growing. I’ve been on this round of chemo since the beginning of August, which feels like a long time.  But it will go on some months longer—and, if things go better than expected, the number of months gets larger. Meaning, the outcome for which I’m rooting involves more of something I hate. On the other hand, when the cancer news turns bad, as one day (probably soon) it will, perhaps I’ll be able to celebrate chemo’s end. Cancer news is always a mix of good and bad.
 
But plainly, this news is mostly good. Thanks to my docs and nurses, thanks to the spouse who sits through every one of those chemo sessions with me, thanks to the friends who pray for me regularly and, most of all, thanks to the God who has seen fit to keep me alive awhile longer.

February 11, 2010

Kids and Computers--Skeel

Thanks to the East Coast blizzard, we’re now in day two of a six day weekend (otherwise known as an eternity) with our two high school sons. This means lots of spirited debates about how long the boys can stay on the computers. In our house, we’ve arrived at a rule that that they can’t go on the computer before 12 noon, and must get off by 10 p.m. My wife and I are pleased with this system (the boys are rather less enthusiastic, and frequently tell us so), but it still means policing the noon and 10 pm boundaries and lots of discussion about how long they can stay on during those hours in between.

At a recent dinner I attended, an executive of a prominent organization told a story about how a young employee had been fired for using Facebook on his work computer, because the organization has a strict rule against employees going on non-work sites.   The principal concern was that surfing the web would interfere with work. When the employee’s boss heard that he’d been fired, he said, “Oh no, he was my most productive employee.” At the dinner table, this led to a predictable discussion of the changes in the way the younger generation processes information and does their work.
 
At home, the story made me wonder whether our after-noon-and-before-10 pm system is hopelessly anachronistic. Maybe it is, but that love for computers looks an awful lot like an addiction to us old timers, and going cold turkey for at least part of the day still seems like the best treatment.
 

March 12, 2010

Santa Maria delle Grazie--Skeel

As she described Santa Maria delle Grazie, the Milan church that houses da Vinci’s “Last Supper,” our tour guide said she so much preferred the name in Italian to its English translation—Saint Mary of Thanks—that she would stick with the Italian henceforth. “Grazie” does seem a prettier word than “thanks,” but I also wondered later if the connection in Italian between thanks (grazie) and grace (grazia; and graces is grazie) also figured in the preference. Grace and thanks are not the same thing, of course, but they are inextricably connected: our thanks are a response to God’s grace. Although I would locate the grace in the work of Christ, rather than Mary, I love the idea that a church “delle Grazie” might refer (if I’m not confused about the Italian) both to God’s manifold grace (or graces) in Christ, and to the thanks of his people, the body of Christ—as expressed generation after generation in the joyous worship in the church.

March 15, 2010

Rome Will be Rome--Skeel

When in Rome, I make a bee-line for the three great Caravaggio paintings of St. Matthew in San Luigi dei Francesi, just east of Piazza Navona. Standing in front of the paintings a few days ago—transfixed by the look of utter certainty on Christ’s scruffy features as he points a narrow finger toward Matthew in The Calling of Matthew [here]-- I realized that it was a good thing that none of my traveling companions had come with me. My gushing would have been unbearable. It occurred to me that this might make a nice topic for a blog post.

And then Rome intervened. The next day we watched six or eight trams go by in the other direction as we started out from our hotel in Trastevere, and none in our direction. The tram finally came after I had given up and had run across the street to try to catch a bus.
 
Last night as I made my way to Piazza del Popolo, which houses another great Caravaggio church, I was slowed by a wave of humanity coursing slowly down Via del Corso. This wasn’t a transportation strike—that was two days earlier—it was an enormous protest against Prime Minister Berlusconi. (A very cheerful protest, I should add. The middle aged Italians carrying signs reminded me of the protestors at a Tea Party rally). I made it nearly to the Piazza before finally giving up.
 
These frustrations alternate with the happy accidents that inevitably accompany them. One of the students on our trip get separated from us as we wandered around the edges of the Forum looking for Perilli’s Rome office, and happened upon a restaurant where she and her husband had eaten during their honeymoon six years ago. After several frustrating shopping expeditions, I finally found a birthday gift for my wife, whose birthday I missed because of the hard time I was doing in Rome. (We’ll see soon if she likes it too …)
 
I think heaven will be a little like Rome: full of aesthetic splendor and moments of pure, unexpected joy—just without the frustrations which, in a fallen world, provide the sharp, Caravaggian contrasts of dark and light that make the joys of Rome so arresting.
 
 

March 18, 2010

Cancer Update--Stuntz

Last week, the docs ordered another set of films; earlier this week, I heard the results. One of my tumors – the one on my liver – is growing again. This means the combination of chemo drugs I was on for the last seven-plus months are no longer working. So my oncologist put me on a new chemo regimen, which, so far, is about as nasty as the one it replaced.

This is not terrible news, but it isn’t good news either. As I understand the situation, there are three plausible chemo regimens for someone in my circumstances, not counting any clinical trials out there. One of those regimens has now proved ineffective. When—realistically, it isn’t “if”—the same thing happens with respect to the other two, I’ll likely be near the end of cancer treatment; palliative care will be all that’s left, and the cancer will take its course. Plainly, I’m not there yet, and hope I won’t be there for awhile. But I’m a step closer.
 
All of which leaves me a little sad. Not surprised: I’ve done better for longer than I had any right to expect, and I think better than my oncologist expected. But still sad. Life on chemo is often unpleasant, but there is still a surprising degree of pleasure and dignity and joy. I love those things, and as anyone in my shoes would, I want more of them. And yet . . .
 
More and more, I’ve come to see my cancer’s natural progression as containing within it great gifts. Cancer steals life, but the theft is slow and happens in stages. None of it catches me by surprise, for which I’m thankful. I’m even more thankful to have the opportunity to finish some work and, especially, to do things for my spouse and our kids that I might not have done had I expected to live a long time yet. Life feels more precious than it did before, yet I don’t feel the need to cling to it as much as I did before. Whatever happens with the course of my treatment—maybe the next set of films will be better; maybe not—I’ll be fine. God is good.

March 22, 2010

Live Link for Stuntz Conference--Skeel

For those of you who can't make it to Cambridge this weekend for the conference but would like to tune in to some or all of it, I'm told that there will be a streaming video here.

March 27, 2010

Stuntz Celebration--Skeel

As hard as it was for Bill to endure the fuss, the celebration at Harvard Law School was, by my lights at least, unforgettable. The papers from the first three panels featured most of the nation’s leading criminal law and criminal procedure scholars, and hopefully will be published as a book. A recurring theme, made by very different scholars in very different ways, was the extent to which Bill’s work has transformed criminal law and criminal procedure scholarship.

The final panel was more pervasively personal.  One example of the stories, from remarks by Ken Abraham, a colleague of Bill’s when he was at the University of Virginia: when Bill was up for tenure at Virginia, two colleagues (one of whom was Pam Karlan, another panelist) got their hands on the stationary used by the central administration, and sent Bill a letter. Although the administration had received Bill’s tenure materials, the letter said, they unfortunately would need to carefully parse each one of his articles. The process would probably take at least six years. Bill fell for the ruse.
 
We didn’t give Bill an opportunity for rebuttal, but he presented the sketch of a new paper on the initial panel.
 
As soon as we have a DVD of the proceedings, I’ll post a link for anyone who’s interested. 

April 9, 2010

The Stuntz Conference Video--Skeel

The earlier link to the conference should now have the video.  It's right here.

And here is an article from the Weekly Standard on the conference.

June 28, 2010

Another Chemo Day--Stuntz

The most recent set of films showed that my cancer was growing again, so I went back on chemo today after an eight-week break. Not exactly fun, but not the worst thing in the world either. I was reminded of that earlier in the day, and reminded again how hard it is to feel sorry for oneself at a cancer center: I saw a child (she looked to be about 12-13 years old) who is here for treatment, and is obviously in worse shape than I’m in. It broke my heart to see her that way, and to think of the grief her parents must be going through. It also impressed me to see how kindly the doctors and nurses treated her. Cancer is a supremely ugly disease, but when skilled and good-hearted people work with cancer patients, sometimes the disease’s treatment takes on a kind of beauty. Heartbreaking beauty—it’s a strange concept, isn’t it?

 

August 3, 2010

Driver's License--Skeel

Our seventeen year old son just got his driver’s license and made his first substantial solo trip today—a twenty-five minute drive to meet up with friends. It occurred to me how much easier it is be a parent now, and how much harder, than when I first started driving (the day I turned sixteen, as was the norm in my era). Thanks to cell phones, we can check up at almost any time—say, after he’s driven about a quarter of a mile. But thanks to cell phones, we can never completely relax, because there’s always the option to give the kids a quick call.

I think our son’s biggest thrill is knowing he can now go to Wawa whenever he wants. (For those of you who don’t live in the Northeast, it’s like a 7-Eleven—a convenience store often attached to a gas station). For some reason, everyone in his peer group thinks that a sandwich from Wawa is a rare delicacy. I’ve been in a lot of Wawas in my time, and the only explanation I can think of is that they must have started drugging the air, or perhaps the sandwiches.

August 25, 2010

Cancer Update--Stuntz

I’ve fallen into the bad habit of posting only when I get some cancer news. It’s a hard habit to break, as I’ve got little energy these days for writing, and am trying to spend it finishing a book. Still, I’d like to break it. Soon.

But for now, some cancer news: Last Thursday I had films taken; this past Monday I heard the results. The bottom line isn’t good. All the cancer they knew about has grown. The stuff has also spread: there are now two tumors in/on my liver, and a host of small ones floating on both sides of my abdomen. Clouds and silver linings travel together, and this is no exception: because these nasty things have been growing and spreading while I’ve been on chemo, they’re stopping the chemo for awhile—a month at least, maybe a bit more. That part of the package feels very good indeed. After the break, I’ll start a new chemo regimen—the last one the docs will try before clinical trials, which I’m not inclined to do. In general, the news is mostly bad but partly good. That’s the way cancer news usually works: circumstances could always be better—but, almost always, they could also be worse.
 
This latest news brings to mind a common phrase: people in my circumstances often say they’re living “on borrowed time.” (Whenever I hear that, I wonder: how do they intend to pay it back?) I’ve never quite understood the metaphor. My time is more gift than debt. Two-and-a-half years ago, I was told my life expectancy was two years. I’m already past my expiration date, with more time—several months at the least—to come. Viewed that way, I’m in astonishingly good shape: teaching this fall, finishing my book, enjoying time with my family. I have little cause for complaint, and much cause for gratitude. So it seems from my world. Even in the wake of bad news.
 
 

February 7, 2011

Bill's Health

As many of you know, Bill’s cancer news is not good. His doctors now have said that he should look at his life expectancy as a matter of weeks, not months. Although Bill is tired nearly all the time, the pain medications have made the pain more bearable than he had feared. As won’t surprise those who know him or have followed his posts, he is in remarkably good spirits. I will post more information soon, but I wanted to give a brief update for the many people who have been thinking about and praying for Bill and his family.

March 15, 2011

Sad News

As many of you probably know, Bill died late last night. The memorial service will be at Park Street Church in Boston this Saturday at 5 p.m. Here is a blog post from the Stuntz family with the news.

Even with all of the forewarning, it’s still a great shock. All day I found myself thinking of questions I wish I could ask Bill. I’ve never seen anyone live out Jesus’s call to love others as we love ourselves the way Bill did. He was of course hugely influential as a scholar and teacher, but I think he may have touched even more hearts by writing, speaking and sharing about his struggles with cancer and debilitating back pain.
 
As it turns out, I’m in Rome, and found myself standing before the great Giotto painting in the Vatican that shows the deaths of Peter and Paul in the lower frames, and their perfect heavenly bodies worshipping God above.   I have to imagine that those who have suffered greatly in the flesh will have more joy than anyone in their resurrected bodies.
 
I’ll link to a number of tributes and other materials in the coming days and weeks.   In the meantime, I, like many of you, will be giving thanks for Bill’s life and praying for his family and everyone whose life he touched.