Living as close as I am to death, I had not expected to be focused on keeping my teeth their whitest. Having been diagnosed with stage IV prostate cancer, my disease has transformed to small cell, a rare form of cancer with few effective treatments. I did take a second treatment of chemotherapy targeted directly at the small cell cancer. It worked, for a while. The chemo beat back the cancer that had grown from my prostate and bones to my liver and lungs. Within a couple of months of completing the treatment, though, the cancer returned to my liver and is now headed back to my lungs.
With hope, I’m presently waiting to learn if I qualify for a stage I small cell clinical trial. Administered by one of the three or four oncologists in the country whose research focuses on prostate-based small cell cancer, the trial has produced positive results, including some with “durability,” a new key word for me. Meanwhile, I start each day knowing my doctor has an impressive research lab devoted to next-generation treatments for my disease. Like so many advanced cancer patients today, my life is closely linked to the speed and creativity of medical science.
In the meantime I’ve been waiting weeks to hear if I’ll be accepted into the clinical trial. It’s now, I believe, a matter of days. It’s fair to say this time has been the most unusual of my 58 years. I’m in mortal limbo.
But there’s something else: what feels like a profound reorientation with the content of time and the heavy repetitiveness of it while I await word on the clinical trial. With such a hard wall before me, I feel a pronounced personal emptiness about what happens between now and then. My conscious hours are marked by a certain stillness in time. Not that time isn’t moving at all. It’s without variance. My days have a striking constant uniformity.
What flows from this cognitive condition is a surprising sense of empowerment within the small world around me. The unchanging content of time provides an opportunity to act in a peculiarly deliberate manner, to behave with an exactitude that presents a heightened promise of cause and effect. I’m not describing a new feeling or idea. Eastern and Western religion and philosophy have long contemplated repetition. It’s Nietzsche’s concept of eternal return: “avail thyself of this happy hour and of the stillness around us.” Power, freedom, and even perfection may follow.
American culture’s most important contribution to understanding the recurrence phenomenon is the 1993 film “Groundhog Day,” in which Bill Murray’s Phil, a Pittsburg TV weatherman, gets stuck in a single-day time loop in Punxsutawney, Pennsylvania, a place for which he has utter contempt. Waking each morning to Sonny and Cher’s “I Got You Babe,” Murray soon discovers that his actions have no consequences. Binge drinking, one-night stands, and joy riding ending in fire and destruction only bring the beginning of the exact same day. Suicide doesn’t end the loop.
Realizing he’s in a kind of purgatory, Murray concentrates on intense self-improvement. With his countless days of time, he learns to speak French, sculpt ice, and play the piano.
He then turns outward. Armed with perfect knowledge of what happens during one day in Punxsutawney, Murray saves people from serious accidents. Every personal encounter and conversation throughout the day is as close and complete as possible. By movie’s end, Murray has studied, befriended and embraced virtually everyone in the small town. And with that, his Groundhog Day time loop is broken. Murray has become a good man. Humility may be his defining virtue.
My day is not unlike Murray’s in the first part of the film. He was physically manic in finding the parameters of his sentence and the few limits of his freedom. My efforts, by contrast, have largely taken place in my interior life. I don’t think anyone knows that I’m pursuing perfection. But an exuberance of opportunity is there. Amidst the still, one finds openings, little tears in time, points where concentration, purpose and will might make a difference.
Small objects of my perfection are changing continually. A few months ago it was a perfectly clean stick at chemo infusion. Today, perfect personal hygiene may have its place, but creature comfort is a lot more fun. Bone-in ribeye, new potatoes in butter and parsley, seared broccolini with garlic.
With my gift of recurrence, though, am I not obligated to aim higher? Shouldn’t my actions make others aware of the perfection I seek? Why should it remain personal and private?
In Punxsutawney, Murray uses his time loop to perfect a full humanitarian sensibility, one replete with moral responsibility to act on the townspeople’s individual longings and community shortcomings that he’s come to know so well. It’s a tall order. And it took him a very long time. The metaphysical premise of “Groundhog Day” allows for a millennium of single days for Murray to grow his democratic fellow feeling and to figure out how to ameliorate the want he sees around him.
A new realm of perfection for me is keen patience for almost anyone or anything that is not word of my clinical trial. Smile, look inside the moment, imagine the disconnected vagaries that make up this unnecessary stretch in time, let it pass easily, continue smiling.
I’m not so sure my two children notice my perfect patience. Or my wife. We’re caught up in learning how to talk and feel about my dying. We’re all far from perfection here. A work that will always be in progress until it isn’t, constructing occasions for sitting down and finding the meaning and implications of my disease is beyond us. Routine updates about my condition and treatments, finding spontaneous moments to drop pragmatically into what the future will likely bring, marking off time to do our favorite things together, and remaining imperfectly patient are the best we have done so far.
Dying is an intensely social experience. Close family and friends’ love and support have been my core post-diagnosis experience. It’s been a pinnacle of my whole life. There’s something close to perfection in such caring’s accumulative emotional effect, an oceanic feeling of collective concern from near and far -- the love that comes from what Quakers call being held in the light.
As for my part in personal encounters with loved ones, friends and colleagues, there is little perfection. Attention to basic integrity and individual autonomy often predominate. The seeping sense of tragedy and despair, the recurring re-registration of shock at the original diagnosis and current decline, the gross calculus of the likely lost living and fun with my people: I can usually hold these cornerstones of my self at bay at parties and in personal conversations. What turns me to the door is the bright line between being subject to death in this immediate way and my interlocutor, family member, friend, or colleague who is not.
I usually stay in conversation and try to listen intently. Patience is required. But that line of mortality between the two of us makes for rather lively play in perspective. Few occasions yield more empathic effort. And with perfection in mind, I imagine us both nearing Murray’s humanitarian sensibility.
My main project now is perfection in hoping. Another tall order, it’s split by real promise in revolutionary treatments and the constant weakness and imperfection of the flesh. I am told that balance can be found between hope and hopelessness, a subject position between ungainful optimism for curing advanced cancer and creating comfort and dignity in death itself. I’m hoping for the best.
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