Based on personal experience, Weisman offers a useful combination of practical advice, philosophical questions, and humorous observations- with a touch of personal memoir. No Expiration Dates presents insights into the many challenges and questions a cancer diagnosis brings for both the patients and their families. Weisman's unique use of literary quotes helps to emphasize the message that a devastating illness is not only survivable but can enlighten previously held perceptions about life.
A blueprint for survival, No Expiration Dates discusses the surreal nature of hospital stays, the fabric of doctor-patient relationships, and the world of chemotherapy. This non-medical guide provides an understanding of the coping mechanisms necessary to meet the emotional and social challenges of a cancer diagnosis. This memoir of discovery and hope helps develop positive paths to the goals of life extension and recovery.
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No Expiration DatesA Cancer Patient's Strategies for Survival
By Leon Weisman
iUniverse, Inc.Copyright © 2009 Leon Weisman
All right reserved.
Chapter OneHospitals, Physicians, and Hospital Time
Nature, time and patience are the three great physicians. -Unknown
Located in the beautiful city of Boca Raton, the community hospital is situated northwest of Deerfield Beach.
The hospital's façade is a medical oxymoron. Palm trees, waterfalls, and a lake landscaped with pink tropical foliage contrast sharply with the vast number of snowbirds who become ill on their southern retreat and seek medical attention within its tropical charm.
A piano player in the lobby greets visitors to the strains of Stravinsky. Sculptures line the corridors, amidst bronze plaques recording the philanthropic gestures of concerned residents. We don't usually think of hospitals as "user-friendly." However, I watched a closed-circuit bingo game presided over by a senior volunteer who awarded prizes to winners.
Winners in a hospital-an interesting twist of fate.
A team of well-tanned medical experts spoke in guarded tones and introduced the specter of lung cancer. All agreed, however, that biopsies must be performed as soon as I returnedhome.
Two days after my emergency admittance to the hospital, my son, Steven, and his darling wife, Lauren, arrived in Boca Raton from their home in Holbrook, New York. This action was greatly appreciated since Steven is an administrator at Stony Brook University Hospital on Long Island. His knowledge of hospital operation provided a high degree of assurance. Steven was in constant communication with his sister, Marlene Weisman-Abadi; her husband, Michael; and seven-year-old Adam.
Steven's sixteen-year-old son, Andrew, arranged to board at a friend's house; and Diane and Bernard Lebowitz, Steven's in-laws, kindly volunteered to care for Shea, their playful West Highland Terrier.
The urgency for immediate internal exploration resulted in my leaving Boca Raton Community Hospital on the evening of Monday, January 29, via air ambulance, for my Long Island hospital.
Situated on Community Drive in Manhasset, New York, North Shore University Hospital fulfills its theme of "setting the standard for medical care." With prompt concern, a medical team was assembled. The attending physician was compassionate and dependable. The oncologist exuded confidence in his planning. The pulmonologist performed the biopsy with precision. A resident physician buoyed my spirits when depression set in. A lanky intern was apologetic when he delivered distressing news.
The hospital housed every conceivable device to delve into the recesses of my body. Their staff of pathologists and radiologists issued their reports with dispatch.
In a display of remarkable devotion, my daughter, Marlene, spent one week in my hospital room, sleeping on a lounge chair. My wife, Sylvia, accompanied her during daytime hours but returned home in the evenings. Steven, Marlene, and Lauren performed Herculean tasks of contacting insurance companies, coordinating hospital activities, and attending to dietary issues.
In addition to attending to my needs, Marlene, Steven, and Lauren provided support and attention for Sylvia, who endures the debilitating pain of lumbar stenosis and osteoarthritis.
A hospital is a cloister of medical scholars. Speaking in strange tongues, they use words meant to explain your condition. The words fly at you as each "ologist" presents his or her findings in measured gaits.
Styles vary. The physician who speaks in whispers reassures his patient by employing an aura of confidence. The doctor who emotes resoundingly projects an image of a living textbook. Some doctors resemble professors, while others portray a picture of "dress-down" casual.
The speed at which physicians can appear at your bedside is impressive. Unannounced, they float in and out, making their daily rounds.
In many respects, doctors resemble judges. They weigh the evidence, consider the alternatives, and offer acquittal, probation, or sentencing.
Is there a definition of time?
Railroad time, airport time, and TV time are examples of precise time and dependability.
The hospital patient enters a befuddling dimension known as "hospital time." Schedules are mere suggestions, appointments are fluid, and daytime and nighttime have lost their power of partition. The work schedules of physicians and hospital staff utilize a twenty-four-hour clock.
The volume of patients awaiting X-rays, CAT and PET scans, and ultrasound tests causes a backup of gurneys, wheelchairs, and hospital beds. Similar to the stacking of airplanes awaiting landing rights at major airports, patients await their turn in silent agony.
When your turn is announced, you enter a room of nuclear-age furnishings-equipment of exploration beyond imagination. With great concern, compassionate technicians insert patients in the devices.
Radiologists and pathologists remain unseen and monitor the "pictures" with eyes entrusted to interpreting secrets entombed within the body.
You issue a sigh of relief when you are dismissed and permitted to return to the comfort of your hospital room. Time will stand still. The hands of hospital clocks move in slow motion.
Everything happens to everybody sooner or later if there is time enough. -George Bernard Shaw Time is the valuable thing a person can spend. -Theophrastus The very first requirement in a hospital is that it should do the sick no harm. -Florence Nightingale There are some remedies worse than the disease. -Publilius Syrus Don't defy the diagnosis, try to defy the verdict. -Norman Cousins
Chapter TwoSharing the News
News travels fast. Bad news travels faster. -Unknown
Some linguists claim news is an acronym for north, east, west, and south-referring to the points of the compass. Others prefer the more conservative definition of "a recent occurrence; of significant importance-an event worthwhile of comment."
Whatever definition you prefer, there exists a situation where relatives, friends, and colleagues need to be informed of your illness.
There was a time when the word "cancer" was unutterable. It was referred to as the "Big C," with people unable to say the word for fear of impending consequences. Times have changed. Restrictions are relaxed, and people are more open to its acceptance.
It will be difficult to keep your illness a secret. Cancer patients become topics of conversation: causes célèbres.
Conversations regarding your situation often start with three familiar words: "Have you heard ...?"
Friends, relatives, and colleagues may not see you at familiar haunts. Your appearance may have changed from loss of hair and weight. Walking may be impaired by loss of balance. How long can you hide the truth from them?
To tell or not to tell is a decision you must make. My decision was to share the news. I was greeted by a series of comments from callers talking with muffled sobs:
Are you sure? How bad is it?
What is the prognosis?
How do they know?
But you never smoked!
Conversations ended in several ways: abruptly, with the caller unable to continue; sympathetically, with the caller offering assurance of recovery; and defiantly, with the caller challenging a higher authority for creating such a catastrophic situation.
For those who choose an indirect communication, e-mail may suffice. However, personal contact is the best way to conduct your mission.
Although I have found all recipients of the news of my lung cancer to be quite compassionate, it would not surprise me that there are hard-liners out there. "Sympathy," they may think, "can be found in the dictionary between symmetry and symphony." However, I believe this reaction is an exception.
In kindergarten, we learn that sharing is caring. Devoted relatives, friends of many years, and workaday colleagues deserve to know. Your pain will be lessened when you share it with many.
Spouses and marriage partners deserve special consideration. Their lives may be directly affected. Keeping them abreast of dates for treatments, blood tests, infusions, and injections is vital. A calendar is an excellent data-keeping device.
Can the onset of cancer affect a marriage or a relationship? Probably. Tensions, uncertainty, schedules, and bills are not conducive to fostering happy times. Both sides must strive to reduce these difficult times.
Bill Cosby said, "The heart of marriage is memories." Don't disregard the past. Recall the good times and build on the love, trust, and partnership of the pre-illness days.
It is better to know some of the questions than all of the answers. -James Thurber
Sticks and stones may break our bones, but words will break our hearts. -Robert Fulghum
The less you talk, the more you're listened to. -Abigail Van Buren
The two words "information" and "communication" are often used interchangeably, but they signify quite different things. Information is giving out, communication is getting through. -Sidney J. Harris
News is the same old thing-only happening to different people. -Unknown
Chapter ThreeChemo World
You're never a loser, until you quit trying. -Mike Ditka
The uninitiated may wonder where chemotherapy takes place. The answer will vary according to the physical layout of the facility. Larger communal areas, individual booths containing a single "lounger," or semi-private spaces where you have one partner are the most common.
My experiences with countless chemotherapy sessions have been in a communal area containing seven reclining chairs with footrests. For most sessions, all seven chairs are occupied. At my center, faux leather in gray, brown, and azure complement the yellow walls, with nary two feet of space separating each chair. Six-foot metal poles held erect by star-shaped pedestals support plastic bags containing chemo protocols.
Magazines are present in a rack attached to the wall, and a supply of used paperbacks lines the windowsill.
Two television sets feed a continuous stream of cable news into the refrigerated air.
Brightly clad nurses hover among the patients in response to the beeping of pumps signaling stoppage of flow into the veins of the recipients. Pumps are quickly reset, and the chemotherapy continues its therapeutic passage.
Patients vary in their activities during chemo sessions, which may last up to five hours.
Snacks appear from tote bags containing cookies, crackers, chips, or candy bars. I recall the smell of a meat sandwich wafting through the chemo sanctuary as one patient munched away, oblivious to the serums coursing through his veins.
After my first unfortunate experience of purging during a chemo session, I made a practice of keeping a plastic bag in my pocket to collect any food reflexively seeking an exit.
To be forewarned is to be forearmed. Chemotherapy requires that a person prepare for surprises. Prepare for the worst but expect the best.
Some cancer patients refuse chemotherapy. Indeed, it is a very significant decision-quite serious and critical. Consider the consequences, your loved ones, and its importance to your recovery. In my situation, refusal was never an option.
Illness is not something a person has, it's another way of being. -Jonathan Miller
When the going gets tough, the tough get going. -Joseph P. Kennedy
Words of comfort, skillfully administered, are the oldest therapy known to man. -Louis Nizer
Correction does much, but encouragement does more. -Wolfgang Von Geothe
The fragrance always stays in the hand that gives the rose. -Hada Bejar
Chapter FourNo Expiration Dates
Oh, never say that you have reached the very end, though leaden skies a bitter future may portend. -Hirsch Glick
Examine your body carefully. Explore its crevasses, nooks, crannies, and recesses.
Can you find an expiration date?
An exploration of your cupboard or refrigerator will reveal a multitude of products stamped with expiration dates. These dates protect the consumer by predicting the product's shelf life and preventing bacteria from accumulating.
Cancer patients do not have expiration dates. Expiration is the nemesis of hope. Expiration is an absolute term bearing no significance for individual consideration.
Why, then, do doctors feel incumbent upon them to pronounce expiration dates on many of their patients? Unfortunately, I was one of them. The shock is devastating and life altering. It argues a "getting-your-house-in-order" attitude, and your Book of Life becomes an instant short story. To hear the words of a death sentence is unimaginable. Its stunning effect is paralytic. How can the recipient of an expiration date by an insensitive physician recover from the initial shock? Your strength rests within the word itself:
The pir is found in "spirit," "inspire," and "respiration"-meaning vitality, breathing, and hope. Look within yourself as well as at the word itself. Derive strength to obliterate any date impregnated on your mind. Statistically they are meaningless, psychologically they are destructive, and intellectually they are spurious.
Removing an expiration date is a gesture of freedom. Renewal of life forces, eyes focused on the future, and sleep-laden nights may result from this change. An expiration date is exclusionary. The cancer patient is cast into a special class of "temporary occupants," whose presence is no longer counted. Cancer patients are very much part of the population-thriving, working, and striving to maintain a normal lifestyle.
In many societies, lepers were outcasts. Fear, mysticism, and fences shut out these people. In today's world, the cancer patient remains an integral part of the fabric of our society.
Coupons and medicines have expiration dates-a sure sign of eventual discard. Terminated and finished, their journey is completed.
For many cancer patients, their journey has just begun.
I am the master of my fate. I am the captain of my soul. -W. E. Henley
I never think of the future. It comes soon enough. -Albert Einstein
You don't get to choose how you're going to die. Or when. You can only decide how you're going to live. -Joan Baez
Dying is a very dull, dreary affair. And my advice to you is to have nothing whatever to do with it. -W. Somerset Maugham
Old age is having too much room in the house and not enough room in the medicine cabinet. -Orben's Current Comedy
Excerpted from No Expiration Dates by Leon Weisman Copyright © 2009 by Leon Weisman. Excerpted by permission.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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Table of Contents
ContentsAbout this Book....................ix
1. Hospitals, Physicians, and Hospital Time....................1
2. Sharing the News....................7
3. Chemo World....................11
4. No Expiration Dates....................15
5. Living with Fatigue....................19
6. Embracing the Insignificant....................25
7. Moving beyond Grief....................29
8. Searching for the Truth....................33
9. Funny Bones....................37
10. Higher-Level Thinking....................41
11. Mothers with Cancer....................49
12. Creating Comfort Zones....................57
13. The Vocabulary of Cancer....................61
14. Death Re-viewed....................65
15. The Arms of Morpheus....................69
16. The Appearance of Men....................73
17. The Difficult Patient....................77
18. Directed Speech....................81
19. Mending Wall....................85
20. Controlling Control....................91
21. Unfulfilled Dreams....................97
22. Releasing Purse Strings....................105
23. Attitude Adjustment....................111