In Treatment

"I'm not a TV person," we've heard some people claim, and we probably envy them to some degree, the way we do those who forgo alcohol or ice cream or avocados. I, on the other hand, am a TV person. Not so much "American Idol" or "Are You Smarter Than A 5th Grader," but I do find myself absorbed by shows that work more like long-form novels, usually dark ones at that. So, I'll have to ask you to trust me when I tell you that shows like Battlestar Galactica, Rescue Me, MI-5, and The Sarah Connor Chronicles tell stories about the human condition today that are as compelling as anything found in Dostoyevsky or Faulkner. Not a substitute for them, but voices that add something to that exploration. Like I said, you'll just have to take my word for it.

As in good novels, I find myself becoming attached to the well-drawn characters in these series, even if on the surface, their life circumstances bear little resemblance to my own. Indeed, it may be precisely because their circumstances are so different (an alcoholic firefighter dealing with post-traumatic stress or a mother defending her son from killer robots) that they allow us to look at the darker sides of life more readily.

Stay with me, people. I promise I'll bring all of this back home to the subject at hand presently. This week, the second season of HBO's In Treatment got under way, starring the remarkable Gabriel Byrne as Paul, a shrink with as many demons as his patients. The show features five half-hour episodes per week, each episode with a different patient. We watch the patients go through therapy in 12-week story arcs that are equally compelling and painful.

While some of the patients bear little resemblance to me, the new season introduced a patient named April, 23 years old, who is trying to come to terms with a diagnosis of lymphoma. She's gone five weeks without telling a soul and is toying with the question of whether to stand up to the disease or let it take her. A little close to home?

She tells the doctor, "Don't ever get a bone marrow biopsy. There's got to be some other way." Yeah, I can absolutely relate to that one. More on that subject in a moment.

Later, he observes, "You seem to me to be really independent, and I can imagine that the idea of accepting treatment, putting yourself in someone else's hands can be really scary."

Paul: "There's an old saying that smokers don't believe that cigarettes will give them cancer because cigarettes have never given them cancer before...I'm wondering if you really believe that you have cancer."

April: "I know I have cancer."

Paul: "Yes, but do you believe what you know?"

I would have found this compelling viewing any day, but for a number of reasons, I've found my mind wandering back to those difficult early days in October and November when this news first broke and began to settle in. I got a brochure in the mail today from the Massachusetts Nonprofit Network, an organization that I helped launch over the past five years and a couple of pages in, I discovered a photo of me (with hair) taken at our statewide conference this past October 24th. That day marked the culmination of years of hard and dogged work by many people to give the nonprofit sector a voice in the dialogue about the future of our state. The hope was (and is) that the values that have made the nonprofit sector distinctive could begin to shape the values of our politics and our state at large. October 24th was one of those rare days in my life where years of tending a garden suddenly bore real fruit.

Toward the end of the conference, my cell phone buzzed and my GP was on the line. I'd had the first CAT scan of my neck the day before and wasn't thinking much of it because my blood work had already come back clean and I was looking at the CAT scan as a formality. So, you can imagine the sinking feeling as I listened to my doctor talk about an abnormal result and the need for a biopsy as soon as possible. Believe me, I went through every emotional phase you could name over the next four or five weeks. There were moments where, like April, I couldn't believe what I knew and I doubted my own capacity to stand up to this disease.

At the risk of sounding maudlin, I'll tell you that three things convinced me that I could do this: the amazing love and support of Kathleen through all of this, my own determination to be there for my boys no matter what, and the sense that beyond anything else, I would never want to be remembered as a man who shirked a fight worth fighting. If I were going to go down, I wanted to be remembered for going down fighting. Fear not, I have no intention of going down anytime soon.

As we approach the end of the fighting phase of this journey, there has been little time for coasting. The week before last, I had to be transfused twice with platelets and then admitted to the hospital for the weekend and transfused with whole red blood because my hematocrit had dropped so low. It was as lousy a week as I've had in this entire battle.

A week ago--the day after I was released from the hospital--I was at Mass General to have my marrow stem cells harvested. The tide really turned in my favor that day. They were looking for a minimum count of 5 cells per million to do the harvest. I had 443, which they told me was the highest they'd ever seen at MGH. That meant that instead of taking three days to harvest enough cells for my transplant, they got enough in four hours.

I felt increasingly better as the week wore on, and I even got through a second bone marrow biopsy on Friday with minimal drama, thanks to the wonders of morphine (Charlie Parker, eat your heart out!). A day after the biopsy and seven days after being admitted to the ER with a 100.6 degree temperature, I was on my bike, covering 19 miles on a beautiful early spring day.

I've learned so much in this fight that it will take a dozen blog entries or perhaps a book to capture and express it all. But one lesson stands out more than most. Good times and bad times are all temporary. I cherish the good days, and I will keep yesterday's bike ride in mind as I slog through three weeks on the transplant ward. And I will not hold onto the dark days, because they slide away as quickly as we are willing to let go of them.