Date: Tue, 25 Mar 1997
From: firstname.lastname@example.org (Mike Moore)
Subject: keeping up
Ann and I recently traveled on business to Florida for which I took the opportunity to print up all of the e-mail notes to browse on the plane.
You guys are terrific!
I am not sure that I belong among you because, while I share many of the thoughts and feelings that are being expressed, I simply do not have time to reflect, create and respond with the frequency and intensity that many of you are doing. In one of Doc's messages, he wondered if there is something about the medium that does not encourage longer messages and deeper contact. This medium is so 90s, and we all find ourselves so pressed by the paradoxes of the information revolution that it falls victim to the culture of which it is an integral part. I'm sure we all recall the alarm that was raised 20 and 30 years ago when the advent of computers led to conjecture that we were going to become sorely challenged by leisure time. Instead, my computers, faxes, e-mail and the like seem to have me revved up higher than ever, and however, agile I might be at tap dancing, I still stumble off the edge of the deck from time to time.
At the risk of appearing disingenuous, Doc's comment that he had not known about Ann and my cancers prompts me to share the following letter which we sent to many friends describing our cancer experience. Obviously, I do take time occasionally to reflect, write and share my life with my friends.
Early October 1994
In June of this year, Ann had a lumpectomy for cancer in her breast. The tissue surrounding the lump and related lymph nodes were clean, and Ann returned to work within a few days of the surgery.
On Sunday of Labor Day weekend, Mande was married in a wedding ceremony in our garden that only Colorado autumn weather could make as exquisite as it was.
The following week, I had surgery removing my right kidney with an encapsulated cancer tumor in it. As with Ann, the "margins" and related lymph nodes were clean. The prognosis is excellent.
These have been times of such portent for us that we want to share them.
* * * * *
Ann was having her annual routine visit with her gynecologist when he sensed a slight mass in her breast. Although he showed Ann where and what he was feeling, she felt nothing. Her gynecologist, Fred Abrams, promptly scheduled a mammogram, an ultrasound, and a visit with a breast cancer surgeon.
The mammogram revealed nothing.
The ultrasound finding was so indeterminate as to prompt the radiologist to suggest that Ann return in 3 to 6 month intervals to follow up to see if it still existed.
The surgeon agreed that we could follow up from time-to-time, but if we continued to see some undefinable mass, we would never know what we were seeing unless we did a biopsy.
We decided to do a biopsy, and found cancer.
The next five days were a terrifying period of suspended animation. There was nothing we could do except move as promptly as the surgeon was able to enter the hospital, perform a lumpectomy, and await reports from the laboratory.
In the cancer-speak of the laboratory, the margins and related lymph nodes were clean. It was extraordinary. In that single message we were able to let go of all that had suspended us for that five days and turn to the process of healing. Ann underwent a program of 25 days of radiation therapy during which she experienced no side effects whatsoever. The day following the conclusion of the radiation therapy we departed on a three day backpack which had been planned for almost a year, and Ann left me in her dust as seems to be our pattern in recent years.
* * * * *
On the last Friday of August, Hopi invited Ann and me to attend her final recording session in a recording studio in North Denver. Hopi had visited the studio earlier in the summer to explore production of a tape of some of her songs. Upon hearing her sing, the manager of the studio persuaded Hopi that he should become her producer, and that they should produce a CD and launch Hopi on her new career. The CD is now in final production and will be released in the next month or so under the title, Hopi.
The session was exhilarating. Even more so for me when, at one point, the producer mused aloud that he would like to have a bass among the backup singers in one of the songs, and before he could say "Jack Robinson" I appeared before him, donned an enormous earmuff/headset, and participated in front of impressive equipment and microphones.
About an hour or so into the session, I began feeling strange. Strange evolved into a distinct pain at the very top of my stomach, kind of at the base of my breast bone, followed by shortness of breath, rather generous perspiration, etc. After an hour or more of this discomfort which continued growing in intensity, Ann noticed that I was not observing or enjoying the session as much as I had when we first arrived, and as soon as they took a break, Hopi and Ann took me out into the lobby. Hopi donned her EMT hat and began a series of questions that apparently she would normally ask a person on an ambulance run with symptoms similar to mine. About the fourth question or so, she turned to Ann with eyes as big as saucers and suggested they call an ambulance immediately because I was having a full borne heart attack!
They quickly decided that Ann could drive me more efficiently to a nearby hospital than the time it would take for an ambulance to come, and without further ado, we piled into the car. Ann undertook what seemed like a rather herky jerky drive in rush hour traffic to a hospital about 5 minutes away. During the entire drive, I kept flashing how unfair it was because, after all, I run Nordic Track 5 or 6 times a week, and I have not eaten more bacon than I can possibly remember. And yet, if these were the symptoms of a heart attack, I was clearly checkin' out.
We arrived at the hospital, and I felt worse than ever. I was rushed into the emergency room with great fanfare. Before I knew it, they had managed to insert some kind of a tube into virtually every orifice of my body and, not being satisfied with that, continued to tape a whole bunch of little things on my chest. Within minutes data began coming back to the doctor on innumerable monitoring and similar devices. The message was universal: healthy as a horse.
And yet, I was in greater discomfort than ever. The doctors, nurses and other emergency room technicians were baffled. On the one hand, they had the data that they love to have suggesting I was healthy as a horse, on the other hand, they were all trained in the empirical method in which they could easily observe that this guy was experiencing the last big one.
Twenty-four hours later, with benefit of hindsight, all was clear: I was passing the mother of all gallstones.
Around 7:00 I suddenly began feeling better. I had been given a shot of morphine a little bit before 7:00, and I turned to the nurse and said, "that felt so good, could we please have another?" Not yet, she replied. A bit later, the attending physician began the common loving-doctor probe of my abdomen. You know, fingers poking in and massaging as deeply as possible every nook and cranny below the rib cage. As his indelicate fingers reached my right side immediately below the rib cage where the gall bladder is located, no probing was necessary. The mere touch almost sent me through the roof it was so tender.
By 9:00 that evening, I was negotiating my release because I felt all better. The doctor was not to be persuaded, insisting that I should remain in the hospital overnight under observation. At this point, they had a cigarette pack-sized device in the pocket of my nightshirt with little wires taped to various parts of my chest and apparently I was sending some kind of a magic message to monitors located throughout the hospital so that everyone who was interested could tell at a glance what was happening to my heart and probably other functions as well.
In any case, I spent a comfortable night at the hospital and the next day underwent an ultrasound as part of the monitoring and observation. The ultrasound reaffirmed the healthy horse message of the monitors of the day before, but revealed a curious mass in my right kidney for which I ought to have a CAT-scan.
By this time, I had introduced the attending physician to my personal physician (Len Wheeler) on the west side of the city, and Len proceeded to arrange a CAT-scan the following Monday morning at the crack-of-dawn.
I went. They did. I felt as terrific as I normally do. Len called about 4:30 Monday afternoon. Len and I have known one another for 30 years. I had never known his tone of voice as when he advised me that I had a very serious tumor in my kidney and that he had arranged for me to visit with a urologist early the next morning.
As I hung up the phone, I was bewildered. My bewilderment lasted until I went to bed that evening. How did I feel? How should I feel? What should I do? Should I share this reality with others, or should I keep it to myself.
Somehow I answered all those questions in my sleep that night. Upon awakening Tuesday morning I had a sense of clarity of purpose and centeredness to my being. I knew that there was nothing to be gained by grappling with the what-ifs. There was nothing to be gained by making any assumptions based upon speculation. Better that I live with and deal with reality as reality was described to me by persons whose opinions I respected.
Brett Abernathy is a urologist more than half of whose surgical practice involves cancer. He had a wonderful presence and instilled terrific confidence and trust of himself in both Ann and me. As we drove down to meet him, I forgot my resolution earlier in the day regarding speculation, and grappled with the question: What if the litany that Brett delivered were the worst imaginable, with a concluding punch line that he had reserved the surgical pavilion for the following morning at 9:00 would I please check in at 7:00 in the morning. If that were the case, I'd have to make a choice: either go into surgery and be hospitalized or wait three days for Mande's wedding.
Brett's litany was as serious as I had imagined. Except, when he got to the punch line, he glanced at my folder, arched an eyebrow, and observed, "Oh, you take aspirin. We cannot operate for 7 days."
Brett advised us that, from his experience reading CAT-scans of this sort of tumor, the odds were 90% it would be cancer. When I suggested we do a biopsy in case it was one of the non-malignant 10%, I learned that, with kidney tumors, biopsies are ill advised because, if there is cancer in the tumor, the medium by which the biopsy was taken instantly creates a path by which the cancer can escape from the tumor and spread into other organs.
I stopped taking aspirin.
I visited with a Nephrologist at the University of Colorado Medical Center for a second opinion. He confirmed that surgical removal of the kidney was the treatment of choice given the diagnosis, and pointed out that my other kidney would simply grow a smidgen bigger and I would then be able to live, smell, eat, taste and be as I always have, with one admonition: be careful when I'm skiing that I don't hit a tree. After some reflection, I realized I'd been dodging trees for the last 45 years so that even my skiing won't have to change! Arrangements were made for the surgery to be done on the Thursday following Labor Day weekend, with pre-op, prep and other activities occurring on Tuesday. I donated a pint of blood at the Blood Bank in the hospital where the surgery would take place, and we turned to Mande's wedding.
* * * * *
Mande met Dave Mischler when they both arrived at Leo Burnett in the same class of MBA inductees four years ago. They have lived together for the last two or three years, and Dave has visited us and we have visited them on numerous occasions. He is a terrific new son-in-law. When they came to visit us last Christmas, Dave apparently was carrying an engagement ring in his pocket. However, he could never find an opportunity to be alone with Mande to propose.
His chance arose Christmas Day morning when we were all sitting around sated with the pleasures of opened Christmas presents and pancakes with special lemon flavoring. Mande and Dave went for a walk and, upon their return, Mande burst into the house showing us her ring and declaring that they were going to be married.
Ann's immediate response was, "You're kidding."
Dave's rejoinder, pointing at Mande without missing a heartbeat was, "That's what she said", .
We were all up at 6:00 the next morning hovering around the dining room table as we began planning the festivities. It really helps if you have 9 months to plan your daughter's wedding.
We anticipated that most of the guests would be from out-of-town, and therefore set our sights on a holiday weekend.
Mande knew she wanted a garden wedding, and between Memorial Day, July 4th and Labor Day weekends, the latter is the most likely to have weather complimenting such a ceremony.
>From January until April, most of the work was planning. Then, I began to notice days when I would come home from the office to find one room in the house completely draped with drop cloths and Ann covered with paint from head-to-toe, "Getting ready for the wedding!"
Probably the most extraordinary gift for all of us came when Glen Lagerstrom, a close and dear friend of Mande's from Stanford, indicated early in the planning process that he would like to come and stay at our home and be in charge of the kitchen. Glen lives in San Francisco, and occasionally caters gourmet functions. His cuisine and his complete management of our kitchen was so liberating for Ann and me as to simply overwhelm us.
Various members of the Mischler family and other close friends began arriving from Dayton and Chicago on Thursday before the weekend. We had wonderful meals, picnics and visiting at our home. Our backyard is mostly Aspen grove with a dense semi-circle of Blue Spruce that were Christmas trees 20 or more years ago, and have all grown to heights ranging from 20 to 30 feet.
Following the rehearsal dinner for the wedding party, we held a hoe-down for all of the wedding guests the night before the wedding. The hoe-down was held at the theater where Ann, the girls and I have performed on stage with the Evergreen Chorale for the past 20 years. At one point during the evening, we introduced the Moore Family Singers. The mother and daughters performed admirably; daddy was a basket case. For all the performing savvy that I have acquired over the years, I could not resist glancing at the faces of the audience. So many dear friends and family caressing us with such looks of joy and love were more than I could manage. After two songs, the girls cut the program short, advised me they would sing one more song and that was it. I watched the rafters during that last song, and realized my folly. It was a well served dress rehearsal for performances the following day.
Throughout the wedding weekend I sensed in looks and conversation with family and friends that the presence of my tumor was more unsettling for them than for me. I was giving it little time or thought. Hopi and I sang (with my gaze firmly in the aspen trees) the John Denver/Placido Domingo duet, Perhaps Love during the wedding ceremony, and a brass quintet from The Denver Brass entertained everyone before and after the ceremony.
Ann and I composed a toast about September weddings (we were married September 9, 1962), and concluded with a duet from the Fantasticks, Try To Remember. . . September and I kept my gaze above everyone's head and pulled it off.
The reception was highlighted by Denver's premier 50's rock and roll artists, The Nacho Men. When they played their first number which is normally intended to warm up the party, the dance floor was promptly packed. They then had to clear the floor to play a first dance for the
Bride and Groom. We rock and rolled late into the evening.
Dave was serenaded by a group of 12 friends with whom a bond had been formed in high school and has continued to this day. They faithfully attend one another's weddings and diligently hammer the family of the bride for clues as to which car, which bags, what destination and other useful tidbits might be known regarding the honeymoon. Ann came upon Nicole and one of this gang going through my ski wardrobe and loading all the heavy wool sweaters and down powder suits they could find to amuse Dave and Mande when they opened their bags at a honeymoon destination in Mexico. Dave, however, was too wily and too experienced a member of this group to be caught by such elementary jesters, and to our knowledge, they arrived in Mexico unscathed.
* * * * *
My surgery was the following Thursday. It lasted about four and a half hours. The tumor was the size of a cantaloupe; approximately 8 inches in diameter. During the week prior to Mande's wedding, two dear friends who are high energy types sat me down and persuaded me that the role model that they sensed I was using, to wit, Ann's lumpectomy and prompt return to work, was not appropriate for the surgery I was about to experience. The doctor had said something about allowing 4 to 6 weeks for recovery, but I had seen what Ann had done and was confident I could emulate her example.
Thank heavens for friends.
Letting go of my various responsibilities was an interesting process. I came to realize that I have a propensity for taking on unusual numbers of responsibilities and tasks, internalizing them into duties, and then living by a code that is duty bound. During that week up until the surgery, I gradually let go of every duty in my life: my various business endeavors, my role as El Gallo in the Evergreen Chorale's production of the Fantasticks scheduled to open in early October, the annual retreat of the regional board of the Environmental Defense Fund, and myriad other "duties". When I went into surgery, I had already internalized my singular duty when I came out: to mend and heal.
At noon the day following surgery, two nurses approached my bedside and asked, "Mike, are you ready to take a walk?".
I looked at them in stark terror. Not at the thought of walking; rather, at the mere thought of getting out of bed! They showed me a simple technique, and with two or three tubes pumping different things into parts of my body, and two or three other tubes pulling fluids out of other parts of my body, I got out of bed, grasped the nurses' elbows and took six steps.
It wasn't that difficult. And the nurses encouraged me that the more walking I did in the following days the quicker I would heal. By the third day I was doing laps around the corridor network of the ward. I think I did 22 laps that afternoon.
When I was awakened the third day after surgery, the nurse's greeting was different than the previous days. This time she asked, "Have we passed any gas yet?". She then explained that passing gas would be an indication that I was ready to start eating solid foods.
The focus was flatus from that moment on. Later that morning, one of our friends arrived at my room with an African drummer and 8 drums. Bateka had come to share some healing drumming with me. In the course of his visit, various family and other friends arrived so that soon the room was jammed packed with at least 12 onlookers and Bateka tapping out absolutely wonderful rhythms. Thirty minutes or so into the seance, his right hand began flicking imperceptibly from time-to-time to tap the biggest drum of all. Though you might not have seen it, you knew it because each time he tapped it the entire room and all of us in it vibrated with the drum. At that point, nurses began appearing somewhat anxiously to indicate that the bass was disturbing other patients, could we please calm it down. In fact, the hospital staff was generously tolerant, and Bateka's rhythms endured long after his departure.
When I finally turned out my light that evening and rested my head on my pillow to go to sleep, I made the most wonderful, loud, lengthy fart you've ever heard. Quick as a wink I was out of bed with my trusty I-V tree rolling beside me as I hastened to the nurses station to proclaim to the assembled multitudes. All 3 of them celebrated with me. Breakfast the next morning included oatmeal, pancakes, bacon (we never have bacon at home, but when I eat breakfast away from home and its on the menu, its almost impossible to resist) and two eggs. I was released from the hospital later that day, and have been home ever since.
My renal cancer is relatively uncommon. The fact of the clean margins and lymph nodes means there is no further treatment suggested though I will obviously be monitoring my health more closely with my physician than I had in the past. With the nurses' encouragement about walking, I have spent most of my time since leaving the hospital hiking and sleeping. Within 10 days of discharge from the hospital, I had a 3 mile hike with approximately 200 vertical feet of descent and ascent which I was doing with increasing vigor at least twice a day, always followed by a wonderful sleep. I'm sure that I will assume many of my duties before the six weeks are up, but I am largely being true to the primary one of mending and healing. Ann and I know that we were helped along on our journeys with all of the love of family and friends. We also know how lucky we are and what an extraordinary reaffirmation of our lives we have recently experienced. We hope this letter finds you in good health and good spirits.
Mike Moore Air Lift Unlimited, 1212 Kerr Gulch, Evergreen, CO 80439
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